Provider Demographics
NPI:1932276136
Name:ZUBA, ANNE S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:S
Last Name:ZUBA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6072 BRYNWOOD DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-5829
Mailing Address - Country:US
Mailing Address - Phone:815-871-6361
Mailing Address - Fax:815-398-2116
Practice Address - Street 1:6072 BRYNWOOD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-5829
Practice Address - Country:US
Practice Address - Phone:815-871-6361
Practice Address - Fax:815-398-2116
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0059921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical