Active NPI
Susan K Marcum, LSW
- Clinical Social Worker
- Gallipolis, OH
National Provider Identifier
1053377689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S0022219
- Practice address
- 936 State Route 107
Gallipolis, OH 45631-8243 - Phone
- (740) 446-4600
- Fax
- (740) 446-2944
- NPI assigned
- Apr 22, 2006
- Last updated
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S0022219 | OH | Primary |
Addresses
Primary practice location
936 State Route 107
Gallipolis, OH 45631-8243
Mailing address
PO Box 390
Huntington, WV 25708-0390
Phone (304) 429-1088
Other practice location 1
420 Silver Bridge Plz
Gallipolis, OH 45631-1861
Phone (740) 446-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0274068 | Medicaid | OH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S0022219 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Valley Physicians Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba OVP Health
- Substance Abuse Rehabilitation Facility
- South Point, OH
- NPI 1750776068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1053377689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 390",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257080390",
"telephone_number": "304-429-1088",
"fax_number": "304-696-1623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "936 STATE ROUTE 107",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456318243",
"telephone_number": "740-446-4600",
"fax_number": "740-446-2944"
}
],
"practiceLocations": [
{
"address_1": "420 Silver Bridge Plz",
"address_purpose": "LOCATION",
"city": "Gallipolis",
"state": "OH",
"postal_code": "456311861",
"country_code": "US",
"telephone_number": "740-446-4600",
"fax_number": "740-446-2944",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARCUM",
"first_name": "SUSAN",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-22",
"last_updated": "2022-06-10",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S0022219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0274068",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.