Provider Demographics
NPI:1932598158
Name:LUBOVICH, DANNY BRUCE (LCAS)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:BRUCE
Last Name:LUBOVICH
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 SPAULDING RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-5212
Mailing Address - Country:US
Mailing Address - Phone:828-652-2919
Mailing Address - Fax:
Practice Address - Street 1:486 SPAULDING RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-5212
Practice Address - Country:US
Practice Address - Phone:828-652-2919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-2512101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)