Provider Demographics
NPI:1134217326
Name:LUBUS, GEORJEAN (LPC LADC)
Entity type:Individual
Prefix:MS
First Name:GEORJEAN
Middle Name:
Last Name:LUBUS
Suffix:
Gender:F
Credentials:LPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD NEW MILFORD RD
Mailing Address - Street 2:SUITE 2A LANDMARK OFFICE BUILDING
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2426
Mailing Address - Country:US
Mailing Address - Phone:203-775-3282
Mailing Address - Fax:203-775-3478
Practice Address - Street 1:2 OLD NEW MILFORD RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2426
Practice Address - Country:US
Practice Address - Phone:203-775-3282
Practice Address - Fax:203-775-3282
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LPC000013101Y00000X
LADC000194101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
240000013CT01OtherANTHEM
215566OtherMHN