Susan Ottenheimer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000809 Issued in CT

Practice address

47 Trumbull St Ste 101
New Haven, CT 06510-1016

Phone

(203) 776-7996

Fax

(203) 453-9065

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Susan Ottenheimer Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1336254572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TRUMBULL ST STE 101",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101016",
            "telephone_number": "203-776-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TRUMBULL ST STE 101",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065101016",
            "telephone_number": "203-776-7996",
            "fax_number": "203-453-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTENHEIMER",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE (LCSW)",
            "identifier": "000809",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN HMC",
            "identifier": "304468",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "140000809CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "OTTENHEIMER",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nurudeen Lucky Osumah, MD, MBA
• Nazokat Otajonova, MD
• Osarugue Otasowie
• Leticia Otchere-Darko, M.D.
• Olubunmi Irene Otolorin, M.D.
• Marwa Oudah
• Gregory Michael Ouellet, MD
• Jennifer Ouellet, MD
• Maggie May Oumov, RN
• Shavonne Larcenia Overton

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.