Carol M Sussal, LCSW SOLE PROPRIETOR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R013809 Issued in NY

Practice address

222 W 14 St
12B
Ny, NY 10011-7226

Phone

(212) 989-5675

Fax

(212) 367-7323

NPI assigned

Feb 28, 2019

Last updated

Feb 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1164989984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 14 ST",
            "address_2": "12B",
            "city": "NY",
            "state": "NY",
            "postal_code": "100117226",
            "telephone_number": "212-989-5675",
            "fax_number": "212-367-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 14 ST",
            "address_2": "12B",
            "city": "NY",
            "state": "NY",
            "postal_code": "100117226",
            "telephone_number": "212-989-5675",
            "fax_number": "212-367-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSAL",
        "first_name": "CAROL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LCSW SOLE PROPRIETOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R013809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bipin Subedi, M.D.
• Tanya Sullivan, NP
• Lisa Rae Summer, LCAT, LMHC, MT-BC
• Catherine Marzon Superable, PT
• Marcy Susman, M.D.
• Doreen P Sweeting, MD
• Siamak Tadayon, PAC
• Yvette Tanhehco, M.D.
• Jessica Teitelbaum
• Reshma Thomas, NP

• Clinical Social Worker in Ny, NY
• Providers in Ny, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.