Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastern Door Licensed Clinical Social Work, PC

Organization Clinical Social Worker · NPI 1528500337

Eastern Door Licensed Clinical Social Work, PC provides Clinical Social Worker services in Rensselaer, New York. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

620 Washington Ave
Rensselaer, NY 12144-1300
Phone: (518) 252-7073
Fax: (518) 252-7073
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Community/Behavioral Health Agency Taxonomy 251S00000X

Record details

NPI number1528500337
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kellyanne Rugenstein — Owner · (518) 252-7073
NPI enumeratedNovember 10, 2016
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing address620 Washington Ave, Rensselaer, NY 12144-1300

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