Active NPI
Sue Mirandy Lederer, LICSW
- Clinical Social Worker
- Greenfield, MA
National Provider Identifier
1114977253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1015428
- Practice address
- 28 High St
Greenfield, MA 01301-2973 - Phone
- (413) 773-1966
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0000688 | VT | |
| Clinical Social Worker | 1041C0700X | 1015428 | MA | Primary |
Addresses
Primary practice location
28 High St
Greenfield, MA 01301-2973
Mailing address
PO Box 752
Greenfield, MA 01302-0752
Phone (413) 773-1966
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010327 | Medicaid | VT |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1015428 | MA | MD | Clinical Social Worker |
| 089-0000688 | VT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355270400000",
"number": "1114977253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 752",
"city": "GREENFIELD",
"state": "MA",
"postal_code": "013020752",
"telephone_number": "413-773-1966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 HIGH ST",
"city": "GREENFIELD",
"state": "MA",
"postal_code": "013012973",
"telephone_number": "413-773-1966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDERER",
"first_name": "SUE",
"middle_name": "MIRANDY",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2012-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "089-0000688",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1015428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1010327",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.