Active NPI
Susan V. Bigelow, MS, LAC, LCAS
- Addiction (Substance Use Disorder) Counselor
- Durham, NC
National Provider Identifier
1104095967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 64
- Practice address
- 705 S Mangum St
Durham, NC 27701-3904 - Phone
- (919) 683-1607
- NPI assigned
- Feb 26, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 64 | CO | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2054 | NC |
Addresses
Primary practice location
705 S Mangum St
Durham, NC 27701-3904
Mailing address
705 S Mangum St
Durham, NC 27701-3904
Phone (919) 683-1607
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6112351 | Medicaid | NC |
Other names 1
- Ms. Susan Virginia Bigelow
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2054 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 64 | CO | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baart Community Healthcare | 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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Durham, NC
- NPI 1376075556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1104095967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 S MANGUM ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013904",
"telephone_number": "919-683-1607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S MANGUM ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277013904",
"telephone_number": "919-683-1607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIGELOW",
"first_name": "SUSAN",
"middle_name": "V.",
"name_prefix": "Ms.",
"credential": "MS, LAC, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-26",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "64",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "2054",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6112351",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "BIGELOW",
"middle_name": "VIRGINIA",
"prefix": "MS.",
"credential": "MS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.