Individual provider Active NPI

Susan Becker, LCSW

  • Social Worker
  • Foxboro, MA
National Provider Identifier
1174628648
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
207446 Issued in MA
Practice address
18 Central St
Suite 5
Foxboro, MA 02035-2425
Phone
(508) 942-2337
Fax
(508) 543-2927
NPI assigned
Sep 13, 2006
Last updated
Jun 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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 207446 MA Primary

Addresses

Primary practice location

18 Central St
Suite 5
Foxboro, MA 02035-2425

Mailing address

18 Central St
Suite 5
Foxboro, MA 02035-2425
Phone (508) 942-2337

Other identifiers 4

IdentifierTypeStateIssuer
P00698208OtherMAPALMETTO RR MEDICARE
799800OtherMATUFTS
008626OtherMAHARVARD PILGRIM HC
5453624OtherMACIGNA

Other names 1

  • Ms. Susan Becker Nisenbaum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040916000706 MA Practitioner - Clinical Social Worker 4981671013 Practice locations: Dedham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

619 High St
Suite 103
Dedham, MA 02026-1877
Phone (508) 942-2337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
207446MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rockhill Counseling & Consulting Group, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1174628648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CENTRAL ST",
            "address_2": "SUITE 5",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352425",
            "telephone_number": "508-942-2337",
            "fax_number": "508-543-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CENTRAL ST",
            "address_2": "SUITE 5",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352425",
            "telephone_number": "508-942-2337",
            "fax_number": "508-543-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "207446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "P00698208",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "799800",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HC",
            "identifier": "008626",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5453624",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BECKER NISENBAUM",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Foxboro, MA

Sources for this page

Verify at the official NPI Registry.