Individual provider Active NPI

Susan Shanfield, LICSW

  • Clinical Social Worker
  • Newton, MA
National Provider Identifier
1093812653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104459 Issued in MA
Practice address
342 Otis St
Newton, MA 02465-2547
Phone
(617) 969-5296
Fax
(617) 969-5296
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 104459 MA Primary

Addresses

Primary practice location

342 Otis St
Newton, MA 02465-2547

Mailing address

342 Otis St
Newton, MA 02465-2547
Phone (617) 969-5296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050928000890 MA Practitioner - Clinical Social Worker 2163457151 Practice locations: Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

342 Otis St
Newton, MA 02465-2547
Phone (617) 969-5296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093812653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 OTIS ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024652547",
            "telephone_number": "617-969-5296",
            "fax_number": "617-969-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 OTIS ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024652547",
            "telephone_number": "617-969-5296",
            "fax_number": "617-969-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANFIELD",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.