Provider Demographics
NPI:1295549822
Name:DUBISCHAR, XENIA JOHANNA (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:XENIA
Middle Name:JOHANNA
Last Name:DUBISCHAR
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 PENNSYLVANIA AVE APT 1029
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2343
Mailing Address - Country:US
Mailing Address - Phone:484-895-5825
Mailing Address - Fax:
Practice Address - Street 1:1300 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3221
Practice Address - Country:US
Practice Address - Phone:484-202-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC018042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional