Individual provider Active NPI

Susan M Gross, LCSW

  • Clinical Social Worker
  • Danbury, CT
National Provider Identifier
1114132180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4089 Issued in CT
Practice address
36 Mill Plain Rd
Suite 312
Danbury, CT 06811-5181
Phone
(203) 744-2660
Fax
(203) 744-5550
NPI assigned
May 13, 2007
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 4089 CT Primary

Addresses

Primary practice location

36 Mill Plain Rd
Suite 312
Danbury, CT 06811-5181

Mailing address

36 Mill Plain Rd
Suite 312
Danbury, CT 06811-5181
Phone (203) 744-2660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050203000780 CT Practitioner - Clinical Social Worker 6507817830 Practice locations: Danbury, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Resolution Counseling LLC Clinical 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.

NPI Registry JSON

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114132180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MILL PLAIN RD",
            "address_2": "SUITE 312",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115181",
            "telephone_number": "203-744-2660",
            "fax_number": "203-744-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MILL PLAIN RD",
            "address_2": "SUITE 312",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115181",
            "telephone_number": "203-744-2660",
            "fax_number": "203-744-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "4089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.