Active NPI
Suzan E. Cowan, ACSW
- Clinical Social Worker
- Jackson, CA
National Provider Identifier
1154540631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ACSW15121
- Practice address
- 1001 Broadway
Suite 201
Jackson, CA 95642-2649 - Phone
- (209) 223-6412
- Fax
- (209) 223-0920
- NPI assigned
- Apr 24, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ACSW15121 | CA | Primary |
Addresses
Primary practice location
1001 Broadway
Suite 201
Jackson, CA 95642-2649
Mailing address
1001 Broadway
Suite 201
Jackson, CA 95642-2649
Phone (209) 223-6412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ACSW15121 | Other | CA | ASSOC.CLINICAL SOCIAL WOR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ACSW15121 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154540631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 BROADWAY",
"address_2": "SUITE 201",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422649",
"telephone_number": "209-223-6412",
"fax_number": "209-223-0920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BROADWAY",
"address_2": "SUITE 201",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422649",
"telephone_number": "209-223-6412",
"fax_number": "209-223-0920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWAN",
"first_name": "SUZAN",
"middle_name": "E.",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ACSW15121",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOC.CLINICAL SOCIAL WOR",
"identifier": "ACSW15121",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, CA
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.