Provider Demographics
NPI:1457744377
Name:RUBIN, MANDY (LPC)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:STAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 INVERNESS DR W STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5000
Mailing Address - Country:US
Mailing Address - Phone:303-730-8858
Mailing Address - Fax:303-889-0838
Practice Address - Street 1:155 INVERNESS DR W STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5000
Practice Address - Country:US
Practice Address - Phone:303-730-8858
Practice Address - Fax:303-889-0838
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional