Active NPI
Susan Fern Lewis, R LCSW, CASAC
- Clinical Social Worker
- Hauppauge, NY
National Provider Identifier
1326367137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R053952-1
- Practice address
- 330 Motor Parkway
Suite 204
Hauppauge, NY 11788 - Phone
- (631) 608-5329
- NPI assigned
- May 19, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10960 | NY | |
| Clinical Social Worker | 1041C0700X | R053952-1 | NY | Primary |
Addresses
Primary practice location
330 Motor Parkway
Suite 204
Hauppauge, NY 11788
Mailing address
37 Shinbone Lane
Commack, NY 11725
Phone (631) 335-5677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110324000313 | NY | Practitioner - Clinical Social Worker | 0648453969 | Practice locations: Commack, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
37 Shinbone LN
Commack, NY 11725-5510
Phone (631) 335-5677
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10960 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| R053952-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1326367137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 SHINBONE LANE",
"city": "COMMACK",
"state": "NY",
"postal_code": "11725",
"telephone_number": "631-335-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MOTOR PARKWAY",
"address_2": "SUITE 204",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "11788",
"telephone_number": "631-608-5329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "SUSAN",
"middle_name": "FERN",
"name_prefix": "Mrs.",
"credential": "R LCSW, CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "10960",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R053952-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.