Susannah Devault

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005290A Issued in IN

Legal business name

SUSANNAH DEVAULT

Practice address

2639 Yeager Rd
West Lafayette, IN 47906-1337

Phone

(765) 532-0569

Fax

(765) 497-9395

NPI assigned

Oct 28, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susannah Devault, LCSW

Title

Licensed Clinical Social Worker

Phone

(765) 532-0569

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1134372741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 YEAGER RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061337",
            "telephone_number": "765-532-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 YEAGER RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061337",
            "telephone_number": "765-532-0569",
            "fax_number": "765-497-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSANNAH DEVAULT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "DEVAULT",
        "authorized_official_first_name": "SUSANNAH",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "765-532-0569",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.