Individual provider Active NPI

Susana Middleton Alvarez, LCSW

  • Clinical Social Worker
  • Irvine, CA
National Provider Identifier
1265688907
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
75609 Issued in CA
Practice address
3532 Eboe St
Irvine, CA 92606-2163
Phone
(562) 822-6767
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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 75609 CA Primary

Addresses

Primary practice location

3532 Eboe St
Irvine, CA 92606-2163

Mailing address

3532 Eboe St
Irvine, CA 92606-2163
Phone (562) 822-6767

Other names 1

  • Susana Middleton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170307000680 CA Practitioner - Clinical Social Worker 1355625591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K Allen Family Therapist IncGroup PAC ID 1951529775, 9 clinicians

Practice addresses (Care Compare)

4 Collingwood
Aliso Viejo, CA 92656-1939
Phone (949) 630-0584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75609CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K Allen Family Therapist Inc CurrentSince Feb 1, 2017 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1265688907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3532 EBOE ST",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062163",
            "telephone_number": "562-822-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 EBOE ST",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062163",
            "telephone_number": "562-822-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "SUSANA",
        "middle_name": "MIDDLETON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANA",
            "last_name": "MIDDLETON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.