Individual provider Active NPI

Susan Stallone Schmid, LCSW,CASAC

  • Clinical Social Worker
  • Huntington, NY
National Provider Identifier
1093955569
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070716-1 Issued in NY
Practice address
243 Vineyard Rd
Huntington, NY 11743-1256
Phone
(347) 356-3943
NPI assigned
Feb 24, 2009
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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 070716-1 NY Primary

Addresses

Primary practice location

243 Vineyard Rd
Huntington, NY 11743-1256

Mailing address

243 Vineyard Rd
Huntington, NY 11743-1256
Phone (347) 356-3943

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
I20151118002745 NY Practitioner - Clinical Social Worker 1557661816 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070716NYMDSocial Worker
070716-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Services Current Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Mar 4, 2019 Accepting new patients
Aid to the Developmentally Disabled, Inc CurrentSince Jan 23, 2023 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

2400 Linden Blvd
Brooklyn, NY 11208
Phone (718) 257-5800

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

901 E Main St
Ste 508
Riverhead, NY 11901
Phone (631) 727-6220

Organizations & group practices 4

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1093955569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 VINEYARD RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117431256",
            "telephone_number": "347-356-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 VINEYARD RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117431256",
            "telephone_number": "347-356-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID",
        "first_name": "SUSAN",
        "middle_name": "STALLONE",
        "credential": "LCSW,CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070716-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.