Susan M Medyn, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1018349 Issued in MA

Practice address

866 Main Rd
Westport, MA 02790-4311

Phone

(781) 789-1236

Fax

(508) 636-0601

NPI assigned

Jul 14, 2006

Last updated

Feb 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1225054976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 NORTH CT",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784724",
            "telephone_number": "401-816-0554",
            "fax_number": "506-636-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 MAIN RD",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027904311",
            "telephone_number": "781-789-1236",
            "fax_number": "508-636-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDYN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1018349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "P05297",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo Mary Long, LICSW
• Breckenridge Marshall, LIC. AC.
• Victoria Olivia Farinha Martin, PSYD
• Emma Masse, DMD
• Erika Medeiros
• Amber Meerbach, M.S.
• Douglas A Mello, DC
• Mary Jane Mello, D.M.D
• Alexia Melo
• Brittany Melo

• Clinical Social Worker in Westport, MA
• Providers in Westport, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.