Individual provider Active NPI

Aija Lubavs, MA

  • Psychologist
  • Portage, MI
National Provider Identifier
1871547653
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301008381 Issued in MI
Practice address
5930 Lovers LN
Portage, MI 49002-1673
Phone
(269) 353-4370
Fax
(269) 344-8696
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301008381 MI Primary

Addresses

Primary practice location

5930 Lovers LN
Portage, MI 49002-1673

Mailing address

2116 Aberdeen Dr
Kalamazoo, MI 49008-1728
Phone (269) 343-3353

Other identifiers 1

IdentifierTypeStateIssuer
P10893971OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301008381MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1871547653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 ABERDEEN DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081728",
            "telephone_number": "269-343-3353",
            "fax_number": "269-344-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 LOVERS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021673",
            "telephone_number": "269-353-4370",
            "fax_number": "269-344-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBAVS",
        "first_name": "AIJA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301008381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P10893971",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.