David Susanin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004901 Issued in CT

Practice address

500 Vine St
Hartford, CT 06112-1639

Phone

(860) 297-0810

Fax

(860) 293-6356

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of Connecticut

  dba Capitol Region Mental Health Center

  • Psychiatric Hospital
  • Hartford, CT
  • NPI 1487689022
  Medicare reassignment

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013091719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 BRIMFIELD RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093206",
            "telephone_number": "860-529-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121639",
            "telephone_number": "860-297-0810",
            "fax_number": "860-293-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSANIN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Suprenant
• Ann-Marie Surette, M.D.
• Surgical Group PC
• Ira Surolia, MD
• Dawn Marie Surprenant, DNP, MSN, FNP-BC, RN
• Edmund Thaddeus Suski, MD
• Emily Hannah Sussman, AU.D.
• Eric Sussman, MD
• Jeston Anne Sussman, LCSW
• Steven K. Sussman, M.D.

• Clinical Social Worker in Hartford, CT
• Providers in Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.