Provider Demographics
NPI:1750356564
Name:DUBS-CERNY, LINDA J (LICSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:DUBS-CERNY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-0303
Mailing Address - Country:US
Mailing Address - Phone:402-643-4954
Mailing Address - Fax:531-727-2073
Practice Address - Street 1:122 S 4TH ST
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2108
Practice Address - Country:US
Practice Address - Phone:402-643-4954
Practice Address - Fax:531-727-2073
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE85101YM0800X
NE10331041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE278700Medicare PIN
NE152445Medicare UPIN
NE237167Medicare UPIN
NE82101Medicare UPIN