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General NPI Number Information
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NPI Number | 1982030110
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Entity Type | Organization
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Legal Business Name | LISA LUBIN, PH.D., L.L.C.
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 6175 S CARSON ST
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City | CENTENNIAL
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State | CO
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Zip | 80111-6071
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Country | US
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Telephone | 303-680-4205
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Fax | 303-680-0489
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Provider Business Mailing Address
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Address Line | 6175 S CARSON ST
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City | CENTENNIAL
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State | CO
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Zip | 80111-6071
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Country | US
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Telephone | 303-680-4205
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Fax | 303-680-0489
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. LISA ROBIN LUBIN
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Credential | PH.D.
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Telephone | 303-680-4205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1489
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1489
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License Number State | CO
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