Susan Lynn Brenner, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I1000141 Issued in OH

Practice address

6942 Tylersville Rd
West Chester, OH 45069-1511

Phone

(513) 868-0055

Fax

(513) 297-7577

NPI assigned

Jul 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Susan Lynn Clock Former name

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4

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.

• Modern Psychiatry & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1699251553
  NPD (past)

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1235441866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6579 KARINCREST DR",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450449548",
            "telephone_number": "513-207-3386",
            "fax_number": "513-777-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6942 TYLERSVILLE RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691511",
            "telephone_number": "513-868-0055",
            "fax_number": "513-297-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1000141",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "I1000141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "CLOCK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Michael Brehm, AT, MED
• Shawn Breidel, LPN
• Peyton Breissinger
• Joyce Brenneman, APRN
• Amy G Brenner, MD
• Rhonda Bridges, LMT
• Donald Brinkman
• Lindsey Brinkman, OT
• Anna Brock
• Mark Brockman

• Clinical Social Worker in West Chester, OH
• Providers in West Chester, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.