Provider Demographics
NPI:1851074629
Name:MUBIN, SAMAH (MA, LAC)
Entity Type:Individual
Prefix:
First Name:SAMAH
Middle Name:
Last Name:MUBIN
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 1:38 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5935
Mailing Address - Country:US
Mailing Address - Phone:201-443-7517
Mailing Address - Fax:
Practice Address - Street 1:25 LINDSLEY DR
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4455
Practice Address - Country:US
Practice Address - Phone:973-998-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00735500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health