Eastern Door Licensed Clinical Social Work, PC
NPI 1528500337ActiveOrganization· Social Worker, Clinical· Rensselaer, NY
Social Worker, Clinical in Rensselaer, New York, registered in NPPES in November 2016. The authorized official on file is Kellyanne Rugenstein, LCSW, PHD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1528500337 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 10, 2016 |
| Last updated in NPPES | Mar 26, 2025 |
| Certified by provider | Mar 26, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
| Community/Behavioral Health | 251S00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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