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
1 NPI 1881748838
2 Entity Type Code 1
3 Provider Last Name Legal Name RUCKENSTEIN
4 Provider First Name DIANE
5 Provider Middle Name E
6 Provider Credential Text LCSW
7 Provider First Line Business Practice Location Address 1527 4TH ST
8 Provider Second Line Business Practice Location Address 200
9 Provider Business Practice Location Address City Name SANTA MONICA
10 Provider Business Practice Location Address State Name CA
11 Provider Business Practice Location Address Postal Code 904012358
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 3105762550
14 Provider Business Practice Location Address Fax Number 3105762499
15 Provider Enumeration Date 1/23/2007
16 Last Update Date 7/8/2007
17 Provider Gender Code F
18 Healthcare Provider Taxonomy Code 1 1041C0700X
19 Provider License Number 1 LCS24113
20 Provider License Number State Code 1 CA
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor N

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This page was last updated on: 8/12/2014
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