Individual provider Active NPI

Suzanne Lee Grierson, LCSW

  • Social Worker
  • Lakeville, PA
National Provider Identifier
1265425722
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CW014961 Issued in PA
Practice address
1258 Purdytown Tpke
Suite 2
Lakeville, PA 18438-6793
Phone
(570) 226-4444
Fax
(570) 226-4333
NPI assigned
Aug 30, 2005
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CW014961 PA Primary
Social Worker 104100000X SC047919 NJ

Addresses

Primary practice location

1258 Purdytown Tpke
Suite 2
Lakeville, PA 18438-6793

Mailing address

67 Oak Mountain Dr
Hawley, PA 18428-8225

Other identifiers 1

IdentifierTypeStateIssuer
PTAN 160320MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000352 PA Practitioner - Clinical Social Worker 5294830006 Practice locations: Lakeville, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone (570) 226-4444

1307 Purdytown Tpke
Suite B
Lakeville, PA 18438-6794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC047919NJMDSocial Worker
CW014961PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suzanne L Grierson PastSince Jan 1, 1990 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1265425722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 OAK MOUNTAIN DR",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184288225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "address_2": "SUITE 2",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-226-4444",
            "fax_number": "570-226-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIERSON",
        "first_name": "SUZANNE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW014961",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "SC047919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PTAN 160320",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, PA

Sources for this page

Verify at the official NPI Registry.