Provider Demographics
NPI:1134381080
Name:LUBLINE, MARC D (LCSW)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:D
Last Name:LUBLINE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 E ARAPAHOE RD
Mailing Address - Street 2:#285
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6114
Mailing Address - Country:US
Mailing Address - Phone:303-725-0492
Mailing Address - Fax:303-904-3321
Practice Address - Street 1:7500 E ARAPAHOE RD
Practice Address - Street 2:#285
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6114
Practice Address - Country:US
Practice Address - Phone:303-725-0492
Practice Address - Fax:303-904-3321
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO991209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO991209OtherCOLORADO LICENSED CLINICAL SOCIAL WORKER LICENSE NUMBER