Provider Demographics
NPI:1710562426
Name:LUBECK, SHARI LYN (LCSWR)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYN
Last Name:LUBECK
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-6553
Mailing Address - Country:US
Mailing Address - Phone:516-485-5976
Mailing Address - Fax:
Practice Address - Street 1:377 OAK ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-6553
Practice Address - Country:US
Practice Address - Phone:516-485-5976
Practice Address - Fax:516-706-8307
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0491461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical