Provider Demographics
NPI:1033245394
Name:HUBERS, BRENDA JEAN (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JEAN
Last Name:HUBERS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 1ST ST S
Mailing Address - Street 2:#225
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-4243
Mailing Address - Country:US
Mailing Address - Phone:320-905-4163
Mailing Address - Fax:
Practice Address - Street 1:1604 1ST ST S
Practice Address - Street 2:#225
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4243
Practice Address - Country:US
Practice Address - Phone:320-905-4163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN95331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical