Individual provider Active NPI

Susan Beatrice Mosher, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1255765855
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149006271 Issued in IL
Practice address
120 S Marion St
Oak Park, IL 60302-2809
Phone
(708) 383-7500
Fax
(708) 383-7780
NPI assigned
Aug 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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 149006271 IL Primary

Addresses

Primary practice location

120 S Marion St
Oak Park, IL 60302-2809

Mailing address

5934 W Midway Park
Chicago, IL 60644-1845
Phone (773) 287-0441

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
149006271ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1255765855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 W MIDWAY PARK",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441845",
            "telephone_number": "773-287-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARION ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022809",
            "telephone_number": "708-383-7500",
            "fax_number": "708-383-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "SUSAN",
        "middle_name": "BEATRICE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149006271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.