Andrea Schreibman Rudolph, LCSW, MSW, MPH

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8642 Issued in CT

Practice address

60 Katona Dr Ste 19
Fairfield, CT 06824-3544

Phone

(203) 257-1009

NPI assigned

Sep 9, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1912308933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 KATONA DR STE 19",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068243544",
            "telephone_number": "203-257-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 KATONA DR STE 19",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068243544",
            "telephone_number": "203-257-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "ANDREA",
        "middle_name": "SCHREIBMAN",
        "credential": "LCSW, MSW, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "8642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008055415",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• RSB Associates D.B.a. Arlyne E Russo
• Ching-Ching Ruan, LMFT
• Lucia Joy Rubin-Cadrain, SLP
• Carrie J Rubin, PH.D, LCSW
• Rubys Happiness LLC
• Keith L. Rudolph, D.D.S.
• Mary Rush, APRN
• Adam Russak, MD
• Sally W Russell, RDH
• Jane A. Russo, D.M.D.

• Clinical Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.