Healthcare Provider Details

I. General information

NPI: 1366372914
Provider Name (Legal Business Name): GREGGY LUBIN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11113 WILTSTAFF DR
MIDLOTHIAN VA
23112-3173
US

IV. Provider business mailing address

11113 WILTSTAFF DR
MIDLOTHIAN VA
23112-3173
US

V. Phone/Fax

Practice location:
  • Phone: 786-247-4786
  • Fax:
Mailing address:
  • Phone: 786-247-4786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGGY LUBIN
Title or Position: OWNER AND MANAGING MEMBER
Credential: DNP, PMHNP-C, WCC
Phone: 786-247-4786