Healthcare Provider Details

I. General information

NPI: 1770860835
Provider Name (Legal Business Name): TAMAR LUBITSH RDT, LPC, PSY D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 ANNAPOLIS DR
ANCHORAGE AK
99508-4310
US

IV. Provider business mailing address

1320 ANNAPOLIS DR
ANCHORAGE AK
99508-4310
US

V. Phone/Fax

Practice location:
  • Phone: 907-538-2008
  • Fax:
Mailing address:
  • Phone: 907-317-9442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number690
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYS118
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: