Provider Demographics
NPI:1669107785
Name:STUBBS, PAUL DONALD
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DONALD
Last Name:STUBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 3RD ST UNIT 661
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-4527
Mailing Address - Country:US
Mailing Address - Phone:386-689-0018
Mailing Address - Fax:
Practice Address - Street 1:3610 REBECCA LN STE 210
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5167
Practice Address - Country:US
Practice Address - Phone:386-689-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical