Provider Demographics
NPI:1326559774
Name:DUBLIN, SHEREE T (MA, LAC)
Entity Type:Individual
Prefix:MRS
First Name:SHEREE
Middle Name:T
Last Name:DUBLIN
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-5510
Mailing Address - Country:US
Mailing Address - Phone:516-967-5969
Mailing Address - Fax:
Practice Address - Street 1:205 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5510
Practice Address - Country:US
Practice Address - Phone:516-967-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00310600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health