Eastern Door Licensed Clinical Social Work, PC
NPI #1528500337 in Rensselaer, New York
Provider Information
- NPI Number
- 1528500337
- Entity Type
- Organization
- Organization Name
- Eastern Door Licensed Clinical Social Work, PC
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Nov 10, 2016
- Last Updated
- Mar 26, 2025
Practice Location
- Address
- 620 WASHINGTON AVE
- City
- Rensselaer
- State
- New York
- ZIP Code
- 12144-1300
- Phone
- (518) 252-7073
Authorized Official
- Name
- KELLYANNE RUGENSTEIN, LCSW, PHD
- Title
- OWNER
- Phone
- (518) 252-7073
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