Individual provider Active NPI

Susana Beatriz Vulijscher, L.C.S.W.

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1144353574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1041CO700X Issued in NY
Practice address
170 W 23Rd St
4 F
New York, NY 10011-2407
Phone
(212) 242-0223
Fax
(212) 242-0223
NPI assigned
Mar 14, 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 1041CO700X NY Primary

Addresses

Primary practice location

170 W 23Rd St
4 F
New York, NY 10011-2407

Mailing address

170 W 23Rd St
4 F
New York, NY 10011-2407
Phone (212) 242-0223

Other identifiers 1

IdentifierTypeStateIssuer
01803149MedicaidNY

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

LicenseStateTypeSpecialty
1041CO700XNYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144353574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W 23RD ST",
            "address_2": "4 F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112407",
            "telephone_number": "212-242-0223",
            "fax_number": "212-242-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W 23RD ST",
            "address_2": "4 F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112407",
            "telephone_number": "212-242-0223",
            "fax_number": "212-242-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VULIJSCHER",
        "first_name": "SUSANA",
        "middle_name": "BEATRIZ",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "1041CO700X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01803149",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.