Individual provider Active NPI

Noah Dzuba, MSW, ASW

  • Social Worker
  • Philadelphia, PA
National Provider Identifier
1073917191
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW63323 Issued in CA
Practice address
604 S Washington SQ Apt 1616
Philadelphia, PA 19106-4125
Phone
(267) 536-5565
NPI assigned
Oct 17, 2014
Last updated
Nov 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ASW63323 CA Primary

Addresses

Primary practice location

604 S Washington SQ Apt 1616
Philadelphia, PA 19106-4125

Mailing address

604 S Washington SQ Apt 1616
Philadelphia, PA 19106-4125
Phone (267) 536-5565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW63323CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibria Psychological and Consultation Services, LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

1516 N 5th St
Unit 401
Philadelphia, PA 19122

525 S 4th St
Ste 471
Philadelphia, PA 19147
Phone (215) 861-3685

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1073917191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S WASHINGTON SQ APT 1616",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064125",
            "telephone_number": "267-536-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WASHINGTON SQ APT 1616",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064125",
            "telephone_number": "267-536-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZUBA",
        "first_name": "NOAH",
        "credential": "MSW, ASW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW63323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.