Provider Demographics
NPI:1629798202
Name:LUBIN-FOSHA, MOLLY SOPHIA (MA, LPC-MHSP, NCC)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:SOPHIA
Last Name:LUBIN-FOSHA
Suffix:
Gender:F
Credentials:MA, LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 WILLIAMS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3195
Mailing Address - Country:US
Mailing Address - Phone:615-653-4115
Mailing Address - Fax:
Practice Address - Street 1:1608 WILLIAMS DR STE 301
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3195
Practice Address - Country:US
Practice Address - Phone:615-653-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5629101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional