Individual
PHILLIP I. SUBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
115 FARABEE DR N, SUITE B-2, LAFAYETTE, IN 47905-5913
(765) 404-9023
(765) 423-5600
Mailing address
115 FARABEE DR N, SUITE B-2, LAFAYETTE, IN 47905-5913
(765) 404-9023
(765) 423-5600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005906A
IN
1041C0700X
Clinical Social Worker
992328
CO
Other
Enumeration date
03/02/2009
Last updated
09/13/2011
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