Individual provider Active NPI

Susan J Sherman, MSW, LCSW

  • Clinical Social Worker
  • Naugatuck, CT
National Provider Identifier
1174802094
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007573 Issued in CT
Practice address
180 Church St Ste 12
Naugatuck, CT 06770-4144
Phone
(203) 525-2113
Fax
(203) 723-3735
NPI assigned
Aug 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 007573 CT Primary

Addresses

Primary practice location

180 Church St Ste 12
Naugatuck, CT 06770-4144

Mailing address

19 Fawn Meadow Dr
Naugatuck, CT 06770-3577
Phone (203) 577-6419

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7573CTMDProfessional Counselor
007573CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Waterbury Oral & Maxillofacial Surgeons LLC PastSince Dec 1, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1174802094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 FAWN MEADOW DR",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067703577",
            "telephone_number": "203-577-6419",
            "fax_number": "203-577-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CHURCH ST STE 12",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067704144",
            "telephone_number": "203-525-2113",
            "fax_number": "203-723-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.