Individual provider Active NPI

Lisa Robin Lubin, PH.D.

  • Clinical Psychologist
  • Centennial, CO
National Provider Identifier
1467517276
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1489 Issued in CO
Practice address
6175 S Carson St
Centennial, CO 80111-6071
Phone
(303) 680-4205
Fax
(303) 680-0489
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1489 CO Primary

Addresses

Primary practice location

6175 S Carson St
Centennial, CO 80111-6071

Mailing address

6175 S Carson St
Centennial, CO 80111-6071
Phone (303) 680-4205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051008000257 CO Practitioner - Clinical Psychologist 4082639109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6175 S Carson St
Centennial, CO 80111-6071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1489COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Lubin, PH.D., L.L.C. CurrentSince Sep 21, 1990 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1467517276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 S CARSON ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116071",
            "telephone_number": "303-680-4205",
            "fax_number": "303-680-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 S CARSON ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116071",
            "telephone_number": "303-680-4205",
            "fax_number": "303-680-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBIN",
        "first_name": "LISA",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.