Individual provider Active NPI

Anne S. Zuba, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1932276136
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.005992 Issued in IL
Practice address
6072 Brynwood Dr
Suite 105
Rockford, IL 61114-5829
Phone
(815) 871-6361
Fax
(815) 398-2116
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 149.005992 IL Primary

Addresses

Primary practice location

6072 Brynwood Dr
Suite 105
Rockford, IL 61114-5829

Mailing address

6072 Brynwood Dr Ste 105
Rockford, IL 61114-5829
Phone (815) 871-6361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150415000383 IL Practitioner - Clinical Social Worker 5799003166 Practice locations: Belvidere, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10117 Pine Valley Cir
Belvidere, IL 61008-7006
Phone (815) 871-6361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.005992ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1932276136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6072 BRYNWOOD DR STE 105",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145829",
            "telephone_number": "815-871-6361",
            "fax_number": "815-398-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 BRYNWOOD DR",
            "address_2": "SUITE 105",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145829",
            "telephone_number": "815-871-6361",
            "fax_number": "815-398-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBA",
        "first_name": "ANNE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.005992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.