Susan Jane Petrillo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R037763 Issued in NY

Practice address

39 Duncan St
Warsaw, NY 14569-1017

Phone

(585) 786-0190

Fax

(585) 786-0196

NPI assigned

Mar 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013049998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HUMPHREY ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699706",
            "telephone_number": "585-786-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 DUNCAN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691017",
            "telephone_number": "585-786-0190",
            "fax_number": "585-786-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R037763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allysa Grace Pascoe I
• Rajendrakumar M Patel, MD
• Katherine M Pawlaczyk, LCSW-R
• Kirsten Perry, FNP-BC
• Christine Peterson, CASAC
• Kiel Pfaff, DNP
• David Michael Pfalzer, NP
• Edward S Piechocki, PA
• Nisar A Piracha, MD
• Cynthia Pond, CSW

• Clinical Social Worker in Warsaw, NY
• Providers in Warsaw, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.