Provider Demographics
NPI:1881913556
Name:DUBBS, LISA R (LCSW-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:DUBBS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:LISA R
Other - Middle Name:R
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7058 MACBETH WAY
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-5920
Mailing Address - Country:US
Mailing Address - Phone:410-552-3778
Mailing Address - Fax:
Practice Address - Street 1:1425 LIBERTY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6420
Practice Address - Country:US
Practice Address - Phone:410-549-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical