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 is a Clinical Social Worker 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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