Individual provider Active NPI

Susannah Dorothy Aquin Mackaye, LCSW

  • Clinical Social Worker
  • Hayward, CA
National Provider Identifier
1356533236
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS20377 Issued in CA
Practice address
409 Jackson St
Hayward, CA 94544-1530
Phone
(510) 891-5545
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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 LCS20377 CA Primary

Addresses

Primary practice location

409 Jackson St
Hayward, CA 94544-1530

Mailing address

409 Jackson St
Hayward, CA 94544-1530
Phone (510) 891-5600

Other practice location 1

2000 Embarcadero
Oakland, CA 94606-5334
Phone (510) 891-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101216000688 CA Practitioner - Clinical Social Worker 0547458614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS20377CAMDClinical Social Worker
20377CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda County CurrentSince Apr 2, 2025 Accepting new patients
Alameda County Current Accepting new patients
Alameda County Behavioral Health Care Past Accepting new patients
County of Alameda Past Accepting new patients

Locations

409 Jackson St
Ste 100
Hayward, CA 94544
Phone (510) 383-5103

409 Jackson St
Hayward, CA 94544
Phone (510) 891-5600

7200 Bancroft Ave
Ste 125A
Oakland, CA 94605
Phone (510) 777-3800

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1356533236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "510-891-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441530",
            "telephone_number": "510-891-5545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Embarcadero",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946065334",
            "country_code": "US",
            "telephone_number": "510-891-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAYE",
        "first_name": "SUSANNAH",
        "middle_name": "DOROTHY AQUIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS20377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.