Individual provider Active NPI

Susan Lynn Hubbard, M.S.W.

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1245437664
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW002531 Issued in MO
Practice address
1750 S Brentwood Blvd
Ste.501
Saint Louis, MO 63144-1315
Phone
(314) 968-3839
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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 SW002531 MO Primary

Addresses

Primary practice location

1750 S Brentwood Blvd
Ste.501
Saint Louis, MO 63144-1315

Mailing address

1750 S Brentwood Blvd
Ste.501
Saint Louis, MO 63144-1315
Phone (314) 968-3839

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
SW002531MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1245437664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 S BRENTWOOD BLVD",
            "address_2": "STE.501",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441315",
            "telephone_number": "314-968-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S BRENTWOOD BLVD",
            "address_2": "STE.501",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441315",
            "telephone_number": "314-968-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "SW002531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.