Individual provider Active NPI

Susan Reed-Imes, LCSW

  • Clinical Social Worker
  • New Port Richey, FL
National Provider Identifier
1245730688
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14461 Issued in FL
Practice address
7702 Massachusetts Ave
New Port Richey, FL 34653-3024
Phone
(727) 847-0069
Fax
(727) 849-3780
NPI assigned
Feb 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 14461 FL Primary

Addresses

Primary practice location

7702 Massachusetts Ave
New Port Richey, FL 34653-3024

Mailing address

7702 Massachusetts Ave
New Port Richey, FL 34653-3024
Phone (727) 847-0069

Other identifiers 2

IdentifierTypeStateIssuer
1619143021MedicaidFL
1245730688MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
14461FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Services, Inc Clinical PastSince Dec 15, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1245730688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 MASSACHUSETTS AVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346533024",
            "telephone_number": "727-847-0069",
            "fax_number": "727-849-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 MASSACHUSETTS AVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346533024",
            "telephone_number": "727-847-0069",
            "fax_number": "727-849-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED-IMES",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619143021",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245730688",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.