DR. STEPHEN GERALD RUDIN (NPI# 1609962976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609962976 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN GERALD RUDIN |
| Credential | ED.D. |
| Practice Address |
1342 Belmont St Suite 204 Brockton MA 02301-4436 |
| Mailing Address |
7301 Nw 18th St No. 204 Margate FL 33063-6857 |
| Practice Telephone | 5084276911 |
| Practice Fax Number | 5085884639 |
| Mailing Telephone | 9549703205 |
| Mailing Fax Number | 9549577505 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY-635-PR | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS HEALTH PLANS | 732869 | 01 |
| MA | HARVARD PILGRIM HEALTH CA | 42279 | 01 |
| MA | MENTAL HEALTH NETWORK MHN | 290594 | 01 |
| MA | BLUE SHIELD OF MASSACHUSE | W01468 | 01 |
| Street Address |
1342 BELMONT ST SUITE 204 |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700873999 | Lyudmila Rakita | Psychiatry & Neurology | 1342 Belmont St, Suite 103, Brockton, MA 02301-4436 | 2005-10-03 |
| 1437666799 | Maureen E. Dimilla | Counselor | 1342 Belmont St, Brockton, MA 02301-4436 | 2018-01-08 |
| 1336692870 | Kayla Pavao | Nurse Practitioner | 1342 Belmont St, Brockton, MA 02301-4436 | 2016-08-02 |
| 1225409253 | Amy Goffredo LLC | Social Worker | 1342 Belmont St, Suite 103, Brockton, MA 02301-4436 | 2015-10-16 |
| 1639515968 | Jennifer Lynn Ulicny | Nurse Anesthetist, Certified Registered | 1342 Belmont St, Brockton, MA 02301-4436 | 2013-05-14 |
| 1588837553 | Lyudmila Rakita M.d.,p.c. | Psychiatry & Neurology | 1342 Belmont St, Suite 103, Brockton, MA 02301-4436 | 2008-04-10 |
| 1013054998 | Karen Hetzel | Clinical Nurse Specialist | 1342 Belmont St, Suite 101, Brockton, MA 02301-4437 | 2007-01-31 |
| 1154498764 | June Louise Chin | Social Worker | 1342 Belmont St, Suite 103, Brockton, MA 02301-4436 | 2006-11-29 |
| 1003902958 | Aubrey Lieberman Md PC | Psychiatry & Neurology | 1342 Belmont St, Suite 105, Brockton, MA 02301-4436 | 2006-10-05 |
| 1750477618 | Aubrey Lieberman | Psychiatry & Neurology | 1342 Belmont St, Suite 105, Brockton, MA 02301-4436 | 2006-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154482545 | Franklin Jerome Galvin | Psychologist | 529 Pearl Street, Brockton, MA 02401 | 2006-12-12 |
| 1912922998 | David V Stringham | Psychologist | 209 Quincy St, Brockton, MA 02302-2926 | 2006-07-12 |
| 1609496652 | Kylee Hagler | Psychologist | 940 Belmont St, Brockton, MA 02301-5596 | 2020-04-20 |
| 1912551276 | Kelly O'malley | Psychologist | 940 Belmont St, Brockton, MA 02301-5596 | 2019-07-25 |
| 1992274914 | Sebastian James Bliss | Psychologist | 940 Belmont St Bldg 5, Brockton, MA 02301-5596 | 2018-11-20 |
| 1144706201 | Claire Michelle Burgess | Psychologist | 940 Belmont St, Brockton, MA 02301-5596 | 2018-07-12 |
| 1043733413 | Michelle Kovacs | Psychologist | 940 Belmont St, Brockton, MA 02301 | 2017-07-18 |
| 1225406606 | Leslie Wright | Psychologist | 940 Belmont St, Brockton, MA 02301-5596 | 2015-09-02 |
| 1467856906 | Shannon Mcneill | Psychologist | 940 Belmont St, Brockton Vamc (116a), Brockton, MA 02301-5596 | 2014-10-13 |
| 1750722096 | Julie Weismoore | Psychologist | 940 Belmont St, Brockton, MA 02301-5596 | 2013-07-16 |
| Find all providers in BROCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.