Provider Demographics
NPI:1417762378
Name:CUBA, ROBERT (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CUBA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11943 182ND AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:WI
Mailing Address - Zip Code:53104-9667
Mailing Address - Country:US
Mailing Address - Phone:262-744-1710
Mailing Address - Fax:
Practice Address - Street 1:1911 27TH ST
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-2542
Practice Address - Country:US
Practice Address - Phone:847-377-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical