Individual provider Active NPI

Susan M Ackerman, MSW

  • Clinical Social Worker
  • Glenwood Springs, CO
National Provider Identifier
1104881234
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
989371 Issued in CO
Practice address
6916 Highway 82
Glenwood Springs, CO 81601-9435
Phone
(970) 945-2583
Fax
(970) 928-8852
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 989371 CO Primary

Addresses

Primary practice location

6916 Highway 82
Glenwood Springs, CO 81601-9435

Mailing address

PO Box 40
Glenwood Springs, CO 81602-0040
Phone (970) 945-2241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210422001417 AZ Practitioner - Clinical Social Worker 2062432339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 E Thomas Rd
Suite 2200
Phoenix, AZ 85012-3133
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
989371COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 29, 2021 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

Interoperability endpoints

  • Direct secure messaging: susanackerman@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104881234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816020040",
            "telephone_number": "970-945-2241",
            "fax_number": "970-945-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6916 HIGHWAY 82",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816019435",
            "telephone_number": "970-945-2583",
            "fax_number": "970-928-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Springs, CO

Sources for this page

Verify at the official NPI Registry.