Individual provider Active NPI

Susan Elizabeth Fila, L.C.S.W.

  • Clinical Social Worker
  • Marina del Rey, CA
National Provider Identifier
1205003993
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
64304 Issued in CA
Practice address
130 Catamaran St Apt 5
Marina del Rey, CA 90292-7803
Phone
(347) 229-3479
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 076097-1 NY
Clinical Social Worker 1041C0700X 64304 CA Primary

Addresses

Primary practice location

130 Catamaran St Apt 5
Marina del Rey, CA 90292-7803

Mailing address

130 Catamaran St Apt 5
Marina del Rey, CA 90292-7803
Phone (347) 229-3479

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

LicenseStateTypeSpecialty
076097-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1205003993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CATAMARAN ST APT 5",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927803",
            "telephone_number": "347-229-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CATAMARAN ST APT 5",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927803",
            "telephone_number": "347-229-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILA",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076097-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "64304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.