EASTERN DOOR LICENSED CLINICAL SOCIAL WORK, PC - NPI 1528500337

Q: What is Eastern Door Licensed Clinical Social Work, PC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

On this page

About Eastern Door Licensed Clinical Social Work, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTERN DOOR LICENSED CLINICAL SOCIAL WORK, PC (NPI 1528500337) is a healthcare organization registered as a clinical in Rensselaer, New York and active in the NPI registry since November 2016. The organization lists Kellyanne Rugenstein, Owner, as its authorized official.

NPPES Registry Identity

NPI1528500337

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameEASTERN DOOR LICENSED CLINICAL SOCIAL WORK, PC

Location Address620 WASHINGTON AVERensselaer, NY 12144-1300

Mailing Address620 Washington AveRensselaer, NY 12144-1300 · (518) 252-7073 · Fax (518) 252-7073

Phone(518) 252-7073

Fax(518) 252-7073

Organization SubpartNo

Authorized OfficialKellyanne RugensteinOwner · (518) 252-7073

Enumeration DateNovember 10, 2016

Last NPPES UpdateMarch 26, 20253 updates tracked since enumeration

NPPES CertifiedMarch 26, 2025

✔ NPI 1528500337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Definition

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.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

620 WASHINGTON AVE, Rensselaer, NY 12144

Open in Google Maps ↗

Other Identifiers 1

Medicaid03068682NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TARYN HEATH

Social Worker