Individual provider Active NPI

Susan Renee Murray, LCSW

  • Clinical Social Worker
  • Johnstown, NY
National Provider Identifier
1083887723
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080710-1 Issued in NY
Practice address
465 N Perry St
Johnstown, NY 12095-1014
Phone
(518) 736-3943
Fax
(518) 762-3533
NPI assigned
Apr 2, 2008
Last updated
May 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 058932-1 NY
Clinical Social Worker 1041C0700X 080710-1 NY Primary

Addresses

Primary practice location

465 N Perry St
Johnstown, NY 12095-1014

Mailing address

465 N. Perry Street
Johnstown, NY 12095-0440
Phone (518) 736-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140203000396 NY Practitioner - Clinical Social Worker 8123257698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc Inc Fulton County ChapterGroup PAC ID 5890717979, 27 clinicians

Practice addresses (Care Compare)

465 N Perry St
Johnstown, NY 12095-1014
Phone (518) 736-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058932-1NYMDSocial Worker
080710-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc Fulton County Chapter CurrentSince May 2, 2013 Accepting new patients

Locations

127 E State St
Gloversville, NY 12078
Phone (518) 773-7931

465 N Perry St
Johnstown, NY 12095
Phone (518) 736-3937

Interoperability endpoints

  • Direct secure messaging: murrays@lexclinic.medentdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1083887723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 N. PERRY STREET",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120950440",
            "telephone_number": "518-736-3943",
            "fax_number": "518-762-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N PERRY ST",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120951014",
            "telephone_number": "518-736-3943",
            "fax_number": "518-762-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "058932-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080710-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, NY

Sources for this page

Verify at the official NPI Registry.