Individual provider Active NPI

Susan K Madson, LCSW

  • Clinical Social Worker
  • Chico, CA
National Provider Identifier
1104987197
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW28954 Issued in CA
Practice address
28 Hanover LN Ste B
Chico, CA 95973-7267
Phone
(949) 521-9049
Fax
(530) 809-4330
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 28954 CA
Clinical Social Worker 1041C0700X LCS28954 CA
Community/Behavioral Health Agency 251S00000X 28954 CA
Clinical Social Worker 1041C0700X LCSW28954 CA Primary

Addresses

Primary practice location

28 Hanover LN Ste B
Chico, CA 95973-7267

Mailing address

28 Hanover LN Ste B
Chico, CA 95973-7267
Phone (949) 521-9049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130206000178 CA Practitioner - Clinical Social Worker 7214181957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS28954CAMDClinical Social Worker
LCSW28954CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Colusa Community/Behavioral Health CurrentSince Aug 7, 2018 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients
Northern California Therapy Services Inc. PastSince Oct 1, 2015 Accepting new patients

Locations

162 E Carson St
Colusa, CA 95932
Phone (530) 458-0520

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 3

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1104987197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 HANOVER LN STE B",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737267",
            "telephone_number": "949-521-9049",
            "fax_number": "530-809-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HANOVER LN STE B",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737267",
            "telephone_number": "949-521-9049",
            "fax_number": "530-809-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSON",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "28954",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28954",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "28954",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW28954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.