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General NPI Number Information
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NPI Number | 1215509096
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Entity Type | Individual
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Provider Name | JASON LUBOSKI LPCC, LPAT, ATR-BC
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Gender | Male
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | 8674 MENTOR AVE STE 6
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City | MENTOR
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State | OH
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Zip | 44060-6143
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Country | US
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Telephone | 440-256-6189
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Fax | 440-549-0939
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Provider Business Mailing Address
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Address Line | 5600 DEERBORN AVE
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City | MENTOR
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State | OH
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Zip | 44060-2008
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Country | US
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Telephone | 440-390-8692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2103538
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License Number State | OH
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