DIANE E RUCKENSTEIN, LCSW - NPI NUMBER 1881748838

Summary

Provider Name: DIANE E RUCKENSTEIN, LCSW

NPI Number: 1881748838

Clasification: Social Worker (1041C0700X)

Specialization: Clinical

Address:
1527 4TH ST
200
SANTA MONICA, CA
ZIP 90401

Phone Number: (310) 576-2550



Detailed Information

Diane E Ruckenstein, LCSW is a clinical social worker in Santa Monica, CA. The provider is a social worker who holds a master�s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master�s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. The assigned NPI number for this provider is 1881748838 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

1527 4TH ST
200
SANTA MONICA, CA
ZIP 90401-358
Phone: (310) 576-2550
Fax: (310) 576-2499

The enumeration date for this NPI number is 1/23/2007 and was last updated on 7/8/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1041C0700X Social Worker Clinical LCS24113 CA Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1881748838 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name RUCKENSTEIN The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name DIANE The first name of the provider, if the provider is an individual.
5 Provider Middle Name E The middle name of the provider, if the provider is an individual.
6 Provider Credential Text LCSW The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 1527 4TH ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Second Line Business Practice Location Address 200 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name SANTA MONICA The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name CA The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 904012358 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 3105762550 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 3105762499 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 1/23/2007 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 7/8/2007 The date that a record was last updated or changed.
17 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 1041C0700X The code designating the provider’s gender if the provider is a person.
19 Provider License Number 1 LCS24113 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 CA The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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