Individual provider Active NPI

Susan Kingsbury, MSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1093041386
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4591C Issued in NV
Practice address
6039 Eldora Ave
Las Vegas, NV 89146-5611
Phone
(702) 493-3312
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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 4591C NV Primary

Addresses

Primary practice location

6039 Eldora Ave
Las Vegas, NV 89146-5611

Mailing address

6039 Eldora Ave
Las Vegas, NV 89146-5611
Phone (702) 493-3312

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

LicenseStateTypeSpecialty
4591CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1093041386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6039 ELDORA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465611",
            "telephone_number": "702-493-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6039 ELDORA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465611",
            "telephone_number": "702-493-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBURY",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "4591C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.