Individual provider Active NPI

Susan C Lerner, LCSW

  • Clinical Social Worker
  • Ithaca, NY
National Provider Identifier
1023191806
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R019539 Issued in NY
Practice address
103 W Seneca St
Suite 200C
Ithaca, NY 14850-4145
Phone
(607) 227-3177
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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 R019539 NY Primary

Addresses

Primary practice location

103 W Seneca St
Suite 200C
Ithaca, NY 14850-4145

Mailing address

504 S Plain St
Ithaca, NY 14850-5240
Phone (607) 227-3177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R019539NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1023191806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 S PLAIN ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505240",
            "telephone_number": "607-227-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W SENECA ST",
            "address_2": "SUITE 200C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504145",
            "telephone_number": "607-227-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERNER",
        "first_name": "SUSAN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R019539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.