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

Ann M Rudolph, L-CSW-R

Individual provider Clinical Social Worker · NPI 1417013723

Ann M Rudolph, L-CSW-R is a Clinical Social Worker in Port Jefferson, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2006

Practice location Address checks out

1000 Main St
Port Jefferson, NY 11777-2250
Phone: (631) 331-4458
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R037202-1 (NY)

Record details

NPI number1417013723
Entity typeIndividual (Type 1)
GenderFemale
Credentials L-CSW-R
Sole proprietorYes
NPI enumeratedDecember 29, 2006
Last updated in NPPESJuly 8, 2007

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