MEDICARE: DR. GREGGY LUBIN DNP, PMHNP-C, WCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0001276199	VA

General Provider Information

NPI Number	:	1467394528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGGY LUBIN DNP, PMHNP-C, WCC

Provider Business Mailing Address
First Line	:	11113 WILTSTAFF DR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-3173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11113 WILTSTAFF DR
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-3173
Country	:	US
Telephone Number	:	786-247-4786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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