Provider Demographics
NPI:1164100194
Name:CUBACUB, ELKA MUSHKA (MSW)
Entity type:Individual
Prefix:
First Name:ELKA
Middle Name:MUSHKA
Last Name:CUBACUB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ELKA
Other - Middle Name:MUSHKA
Other - Last Name:MELAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 W HELENA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-6554
Mailing Address - Country:US
Mailing Address - Phone:773-895-9444
Mailing Address - Fax:
Practice Address - Street 1:16601 N 40TH ST STE 216
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3354
Practice Address - Country:US
Practice Address - Phone:623-473-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-232691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical