Active NPI
Susan J. Berger, LCSW
- Clinical Social Worker
- Stony Brook, NY
National Provider Identifier
1316069818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R034253-1
- Practice address
- 38 Woodbine Ave
Stony Brook, NY 11790-1544 - Phone
- (631) 246-8946
- Fax
- (631) 689-0451
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | R034253-1 | NY | Primary |
Addresses
Primary practice location
38 Woodbine Ave
Stony Brook, NY 11790-1544
Mailing address
38 Woodbine Ave
Stony Brook, NY 11790-1544
Phone (631) 246-8946
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 9, 2023 through Feb 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R034253-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316069818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 WOODBINE AVE",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117901544",
"telephone_number": "631-246-8946",
"fax_number": "631-689-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 WOODBINE AVE",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117901544",
"telephone_number": "631-246-8946",
"fax_number": "631-689-0451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGER",
"first_name": "SUSAN",
"middle_name": "J.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R034253-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.