Provider Demographics
NPI:1487023651
Name:LUBINSKI, AISHA KASHIF (LPC, RD, LD)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:KASHIF
Last Name:LUBINSKI
Suffix:
Gender:F
Credentials:LPC, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14323 S OUTER 40 RD STE 512S
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5734
Mailing Address - Country:US
Mailing Address - Phone:314-246-9395
Mailing Address - Fax:314-689-0395
Practice Address - Street 1:14323 S OUTER 40 RD STE 512S
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-5734
Practice Address - Country:US
Practice Address - Phone:314-246-9395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018005482101YP2500X
MO2012035160133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered