Provider Demographics
NPI:1366658379
Name:LUBOWITZ, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LUBOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12434 LUSHER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-1456
Mailing Address - Country:US
Mailing Address - Phone:314-355-4180
Mailing Address - Fax:314-355-4184
Practice Address - Street 1:12434 LUSHER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-1456
Practice Address - Country:US
Practice Address - Phone:314-355-4180
Practice Address - Fax:314-355-4184
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0021511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical