Individual provider Active NPI

Susan Brown, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1144629189
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13617 Issued in MD
Practice address
711 W 40TH St Ste 358
Baltimore, MD 21211-2111
Phone
(443) 350-0813
Fax
(484) 805-7166
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 13617 MD Primary

Addresses

Primary practice location

711 W 40TH St Ste 358
Baltimore, MD 21211-2111

Mailing address

711 W 40TH St Ste 358
Baltimore, MD 21211-2111
Phone (443) 350-0813

Other identifiers 1

IdentifierTypeStateIssuer
0811807 00MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150617000467 MD Practitioner - Clinical Social Worker 8325359383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

711 W 40TH St
Suite 358
Baltimore, MD 21211-2111
Phone (443) 350-0813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sue Brown, LLC Clinical CurrentSince Jan 4, 2016 Accepting new patients

Locations

711 W 40th St
Ste 358
Baltimore, MD 21211
Phone (443) 350-0813

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": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1144629189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST STE 358",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112111",
            "telephone_number": "443-350-0813",
            "fax_number": "484-805-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST STE 358",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112111",
            "telephone_number": "443-350-0813",
            "fax_number": "484-805-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUSAN",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0811807 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.