Individual provider Active NPI

Susan Elizabeth Lake-Rawson, LCSW

  • Social Worker
  • Gainesville, FL
National Provider Identifier
1265614648
Registry record updated May 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ISW 4615 Issued in FL
Practice address
612 SW 26TH PL
Gainesville, FL 32601-9052
Phone
(352) 213-2920
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2019

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
Social Worker 104100000X ISW 4615 FL Primary

Addresses

Primary practice location

612 SW 26TH PL
Gainesville, FL 32601-9052

Mailing address

612 SW 26TH PL
Gainesville, FL 32601-9052
Phone (352) 213-2920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170217002104 FL Practitioner - Clinical Social Worker 3476836370 Practice locations: Gainesville, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

612 SW 26TH PL
Gainesville, FL 32601-9052
Phone (352) 213-2920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW 4615FLMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558137600000",
    "number": "1265614648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SW 26TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326019052",
            "telephone_number": "352-213-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SW 26TH PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326019052",
            "telephone_number": "352-213-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE-RAWSON",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2019-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW 4615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.