Individual provider Active NPI

Susan Benson Emrick, LCSW

  • Social Worker
  • Vancouver, WA
National Provider Identifier
1134445521
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L4590 Issued in OR
Practice address
14002 NE 100TH Cir
Vancouver, WA 98682-1755
Phone
(360) 896-8167
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L4590 OR Primary

Addresses

Primary practice location

14002 NE 100TH Cir
Vancouver, WA 98682-1755

Mailing address

14002 NE 100TH Cir
Vancouver, WA 98682-1755
Phone (360) 896-8167

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L4590ORMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1134445521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14002 NE 100TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821755",
            "telephone_number": "360-896-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14002 NE 100TH CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821755",
            "telephone_number": "360-896-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMRICK",
        "first_name": "SUSAN",
        "middle_name": "BENSON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L4590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2010; 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.