Jake Sussman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06194300 Issued in NJ

Practice address

615 Sherwood Pkwy
Mountainside, NJ 07092-2525

Phone

(732) 991-7248

NPI assigned

Apr 3, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1245935931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHERWOOD PKWY",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922525",
            "telephone_number": "732-991-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHERWOOD PKWY",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922525",
            "telephone_number": "732-991-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "JAKE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06194300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stepping Stones Pediatric Therapy LLC
• Van S Stevens, DMD
• Lisa A Sturm, MSW, LCSW
• Sunrise House Foundation, Inc.
• Supportive Space Counseling Center
• Steven Sussman, PH.D.
• Jessica Ann Sweeney, M.S. ED., CCC-SLP
• Dolores Switaj, PHD
• Allyson Taylor, PHARMD
• Stuart Curtis Thau

• Clinical Social Worker in Mountainside, NJ
• Providers in Mountainside, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.