Susan Wade-Infanzon, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1451 W Cypress Creek Rd
Suite 300
Fort Lauderdale, FL 33309-1961

Phone

(954) 489-2828

Fax

(954) 324-8354

NPI assigned

Apr 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Wade Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Blue Moon Senior Counseling

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1205129186
  NPD (past)

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1215294103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 W CYPRESS CREEK RD",
            "address_2": "SUITE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091961",
            "telephone_number": "954-489-2828",
            "fax_number": "954-324-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 W CYPRESS CREEK RD",
            "address_2": "SUITE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091961",
            "telephone_number": "954-489-2828",
            "fax_number": "954-324-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE-INFANZON",
        "first_name": "SUSAN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WADE",
            "credential": "L.C.S.W.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heike Von Kahle
• Reza Voosoughi, MD
• VR Counseling Inc.
• W R Rosen Inc (Restore OPC)
• Nathalie Sofi Wacher, MD
• Jennifer Marie Wade, PA-C
• Thomas Wade, M.D.
• Carol Ann Wadelam
• Perminder Wadhwa, DDS
• Wael Z Tamim M D P a

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.