Individual provider Active NPI

Susan Ileana Lindstrom

  • Counselor
  • Salisbury, MD
National Provider Identifier
1275814451
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2336 Goddard Pkwy
Salisbury, MD 21801-1126
Phone
(410) 334-6961
Fax
(410) 334-6362
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

2336 Goddard Pkwy
Salisbury, MD 21801-1126

Mailing address

2336 Goddard Pkwy
Salisbury, MD 21801-1126
Phone (410) 334-6961

Other identifiers 2

IdentifierTypeStateIssuer
609550001MedicaidMD
609550002MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 17, 2019 through Jul 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05741MDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1275814451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 GODDARD PKWY",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011126",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 GODDARD PKWY",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011126",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "SUSAN",
        "middle_name": "ILEANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550001",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.