Provider Demographics
NPI:1548725492
Name:RUBENSTEIN-SPOONT, CAROLYN LISA (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:LISA
Last Name:RUBENSTEIN-SPOONT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:RUBENSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:7220 QUEENFERRY CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-5953
Mailing Address - Country:US
Mailing Address - Phone:561-235-8100
Mailing Address - Fax:
Practice Address - Street 1:4600 LINTON BLVD STE 310
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-223-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10362103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling