Provider Demographics
NPI:1811582364
Name:SHAND-LUBBERS, RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:SHAND-LUBBERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WALNUT CRES
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4919
Mailing Address - Country:US
Mailing Address - Phone:202-360-7761
Mailing Address - Fax:
Practice Address - Street 1:41 WALNUT CRES
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4919
Practice Address - Country:US
Practice Address - Phone:202-360-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00748700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional