Individual provider Active NPI

Susan Yanni-Bosco, LCSW

  • Clinical Social Worker
  • Scarsdale, NY
National Provider Identifier
1356000756
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P054544-1 Issued in NY
Practice address
15 Kingston Rd
Scarsdale, NY 10583-1147
Phone
(914) 772-2205
NPI assigned
Dec 13, 2021
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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 P054544-1 NY Primary

Addresses

Primary practice location

15 Kingston Rd
Scarsdale, NY 10583-1147

Mailing address

15 Kingston Rd
Scarsdale, NY 10583-1147
Phone (914) 772-2205

Other identifiers 1

IdentifierTypeStateIssuer
P054544-1OtherNYNYS DEPT OF EDUCATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P054544-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1356000756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 KINGSTON RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831147",
            "telephone_number": "914-772-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 KINGSTON RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831147",
            "telephone_number": "914-772-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNI-BOSCO",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P054544-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS DEPT OF EDUCATION",
            "identifier": "P054544-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.