Individual provider Active NPI

Susannah Katherine Holub, LSW

  • Clinical Social Worker
  • Pennsville, NJ
National Provider Identifier
1669338158
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL07044000 Issued in NJ
Practice address
5 Carroll Ave Ste 5
Pennsville, NJ 08070-2129
Phone
(856) 209-3799
NPI assigned
Dec 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SL07044000 NJ Primary

Addresses

Primary practice location

5 Carroll Ave Ste 5
Pennsville, NJ 08070-2129

Mailing address

3229 W Penn St
Philadelphia, PA 19129-1017
Phone (215) 764-9062

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SL07044000NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1669338158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 W PENN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291017",
            "telephone_number": "215-764-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CARROLL AVE STE 5",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702129",
            "telephone_number": "856-209-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUB",
        "first_name": "SUSANNAH",
        "middle_name": "KATHERINE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL07044000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.