Susan M Exworthy, LCSW CSAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8922-123 Issued in WI

Practice address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401

Phone

(920) 746-0510

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oneida Nation 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oneida Nation

  • Clinic/Center
  • Oneida, WI
  • NPI 1740278308

  WI

  Medicare reassignment Care Compare group NPD
• Oneida Nation

  • Skilled Nursing Facility
  • Oneida, WI
  • NPI 1407916174
  Care Compare group
• Oneida Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1205825130
  NPD

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1306231683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-746-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-746-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXWORTHY",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "LCSW CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15999-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8922-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley N Earwood, COTA
• Sara Downing Edwards, M.A., ABD, L.P.C.
• Joel A. Eggert, D.D.S.
• Ann Enid Emmerich, PT
• James L Evers, PT
• Eyes for You Inc
• Paul Andrew Filar, O.D.
• Martin Finck, M.D.
• Keith C. Fisher, PT, OCS, MTC
• Caitlin Victoria Mary Fleming, MD/MBA

• All providers in Sturgeon Bay, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.