Active NPI
Susan Clinton, OTR/L
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1053704056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 019539
- Practice address
- 440 Avenue P
Brooklyn, NY 11223-1935 - Phone
- (718) 376-5510
- Fax
- (718) 376-6506
- NPI assigned
- Mar 15, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 019539 | NY | Primary |
Addresses
Primary practice location
440 Avenue P
Brooklyn, NY 11223-1935
Mailing address
440 Avenue P
Brooklyn, NY 11223-1935
Phone (718) 376-5510
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 |
|---|---|---|---|
| 019539 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Especial Education Associates | 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 and National Provider Directory roles.
-
- Counselor
- Brooklyn, NY
- NPI 1508171059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426377600000",
"number": "1053704056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 AVENUE P",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112231935",
"telephone_number": "718-376-5510",
"fax_number": "718-376-6506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 AVENUE P",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112231935",
"telephone_number": "718-376-5510",
"fax_number": "718-376-6506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINTON",
"first_name": "SUSAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-15",
"last_updated": "2015-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "019539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.