Individual provider Active NPI

E Susan Bibby

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1174635544
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS8173 Issued in CA
Practice address
6621 E Pacific Coast Hwy Ste 220
Long Beach, CA 90803-4239
Phone
(562) 858-0663
Fax
(562) 596-6443
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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 LCS8173 CA Primary

Addresses

Primary practice location

6621 E Pacific Coast Hwy Ste 220
Long Beach, CA 90803-4239

Mailing address

6621 E Pacific Coast Hwy Ste 220
Long Beach, CA 90803-4239
Phone (562) 858-0663

Other identifiers 1

IdentifierTypeStateIssuer
CSW0813730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS8173CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1174635544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 E PACIFIC COAST HWY STE 220",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034239",
            "telephone_number": "562-858-0663",
            "fax_number": "562-596-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 E PACIFIC COAST HWY STE 220",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034239",
            "telephone_number": "562-858-0663",
            "fax_number": "562-596-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBBY",
        "first_name": "E",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS8173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW0813730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.