Individual provider Active NPI

Roy A Szubski, LISW, LICDC

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1679883482
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I3011 Issued in OH
Practice address
7800 Detroit Ave
Cleveland, OH 44102-2814
Phone
(216) 939-3721
Fax
(216) 631-3654
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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 I3011 OH Primary

Addresses

Primary practice location

7800 Detroit Ave
Cleveland, OH 44102-2814

Mailing address

7800 Detroit Ave
Cleveland, OH 44102
Phone (216) 939-3721

Other identifiers 1

IdentifierTypeStateIssuer
1041C0700XMedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1679883482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44102",
            "telephone_number": "216-939-3721",
            "fax_number": "216-631-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022814",
            "telephone_number": "216-939-3721",
            "fax_number": "216-631-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZUBSKI",
        "first_name": "ROY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I3011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.