Provider Demographics
NPI:1356988943
Name:DUBINA, STACY RENE' (LPC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:RENE'
Last Name:DUBINA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 VINE ST
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1714
Mailing Address - Country:US
Mailing Address - Phone:724-797-3797
Mailing Address - Fax:
Practice Address - Street 1:442 W MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2552
Practice Address - Country:US
Practice Address - Phone:724-986-0479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health