Active NPI
Susan Dawn Worthen, LICSW
- Clinical Social Worker
- Fall River, MA
National Provider Identifier
1306060397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW02004
- Practice address
- 386 Stanley St
Fall River, MA 02720-6009 - Phone
- (508) 679-5222
- Fax
- (508) 676-5671
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW02004 | RI | Primary |
Addresses
Primary practice location
386 Stanley St
Fall River, MA 02720-6009
Mailing address
386 Stanley St
Fall River, MA 02720-6009
Phone (508) 679-5222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ISW02004 | Other | RI | LICSW LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| ISW02004 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1306060397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "386 STANLEY ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027206009",
"telephone_number": "508-679-5222",
"fax_number": "508-676-5671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "386 STANLEY ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027206009",
"telephone_number": "508-679-5222",
"fax_number": "508-676-5671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHEN",
"first_name": "SUSAN",
"middle_name": "DAWN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW02004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICSW LICENSE",
"identifier": "ISW02004",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.