Individual provider Active NPI

Susan Diann Gaskins, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1336476084
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084441 Issued in NY
Practice address
635 James St
Syracuse, NY 13203-2226
Phone
(315) 671-2964
Fax
(315) 671-2943
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 084441 NY Primary

Addresses

Primary practice location

635 James St
Syracuse, NY 13203-2226

Mailing address

635 James St
Syracuse, NY 13203-2226
Phone (315) 671-2964

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160715001737 NY Practitioner - Clinical Social Worker 2769774496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Liberty Resources IncGroup PAC ID 4486703352, 82 clinicians

Practice addresses (Care Compare)

1045 James St
Syracuse, NY 13203-2730
Phone 31547244711384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084441NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Liberty Resources, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Liberty Resources Inc. Current Accepting new patients
Arise Child and Family Service Inc CurrentSince Jun 1, 2016 Accepting new patients

Locations

635 James St
Syracuse, NY 13203
Phone (315) 472-3171

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1336476084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032226",
            "telephone_number": "315-671-2964",
            "fax_number": "315-671-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032226",
            "telephone_number": "315-671-2964",
            "fax_number": "315-671-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKINS",
        "first_name": "SUSAN",
        "middle_name": "DIANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.