Individual provider Active NPI

Susan A Vincent, LICSW

  • Clinical Social Worker
  • New Bedford, MA
National Provider Identifier
1023092079
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106939 Issued in MA
Practice address
3 N Orchard St
New Bedford, MA 02740-3661
Phone
(508) 991-4404
Fax
(508) 996-4862
NPI assigned
Dec 2, 2005
Last updated
Dec 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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 106939 MA Primary

Addresses

Primary practice location

3 N Orchard St
New Bedford, MA 02740-3661

Mailing address

PO Box 604
Fairhaven, MA 02719-0604
Phone (508) 991-4404

Other identifiers 3

IdentifierTypeStateIssuer
1890492MedicaidMA
104967OtherMAMAGELLAN
755196OtherMATUFTS HEALTH PLAN

Other names 1

  • Ms. Susan A Bell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20051202000608 MA Practitioner - Clinical Social Worker 0244250363 Practice locations: New Bedford, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 Union St
New Bedford, MA 02740-3665
Phone (508) 991-4404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106939MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South County Psychiatry LLC Clinical Past Accepting new patients
Linda M Palmer, Aprn, BC, LLC Past Accepting new patients
Anadyne Psychotherapy, Inc. Clinical PastSince May 1, 2004 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1023092079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027190604",
            "telephone_number": "508-991-4404",
            "fax_number": "508-996-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 N ORCHARD ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403661",
            "telephone_number": "508-991-4404",
            "fax_number": "508-996-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1890492",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "104967",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "755196",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BELL",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.