Provider Demographics
NPI:1144655663
Name:GOLUB-GINSBURG, VITA (LMHC)
Entity type:Individual
Prefix:
First Name:VITA
Middle Name:
Last Name:GOLUB-GINSBURG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-4718
Mailing Address - Country:US
Mailing Address - Phone:781-749-9227
Mailing Address - Fax:781-489-5902
Practice Address - Street 1:175 DERBY ST
Practice Address - Street 2:STE 2
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4007
Practice Address - Country:US
Practice Address - Phone:781-749-9227
Practice Address - Fax:781-489-5902
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health