Provider Demographics
NPI:1073978896
Name:LUBICK, JENNY (MSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:LUBICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 MANOR STONE ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-2949
Mailing Address - Country:US
Mailing Address - Phone:702-378-6480
Mailing Address - Fax:
Practice Address - Street 1:6655 W SAHARA AVE STE A212
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2812
Practice Address - Country:US
Practice Address - Phone:702-826-2759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator