Individual provider Active NPI

Durina Tah, LCSW

  • Social Worker
  • Mesa, AZ
National Provider Identifier
1104400548
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW18085 Issued in AZ
Practice address
777 W Southern Ave
Mesa, AZ 85210-5008
Phone
(602) 279-5262
NPI assigned
May 11, 2021
Last updated
May 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW18085 AZ Primary
Mental Health Counselor 101YM0800X LCSW-18085 AZ

Addresses

Primary practice location

777 W Southern Ave
Mesa, AZ 85210-5008

Mailing address

777 W Southern Ave
Mesa, AZ 85210-5008
Phone (602) 279-5262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221202000835 TX Practitioner - Clinical Social Worker 8527437110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-18085AZMDMental Health Counselor
LCSW18085AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rezilient Healing, LLC CurrentSince Mar 5, 2023 Accepting new patients
Native Health Past Accepting new patients
Native Health Mental Health PastSince May 24, 2026 Accepting new patients
Cartwheel Health Services PC Mental Health Past Accepting new patients

Organizations & group practices 5

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": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1104400548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105008",
            "telephone_number": "602-279-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105008",
            "telephone_number": "602-279-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAH",
        "first_name": "DURINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW18085",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCSW-18085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.