Provider Demographics
NPI:1275585358
Name:LUBIN, PEGGY R (LPCMH)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:R
Last Name:LUBIN
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2819
Mailing Address - Country:US
Mailing Address - Phone:302-425-4884
Mailing Address - Fax:302-425-4884
Practice Address - Street 1:2401 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 103-B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1401
Practice Address - Country:US
Practice Address - Phone:302-425-4884
Practice Address - Fax:302-425-4884
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health