Active NPI
Susanne Wachtel, L.M.S.W. AND C.S.W.
- Clinical Social Worker
- Melville, NY
National Provider Identifier
1356559447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 069056
- Practice address
- 47 Villas Cir
Melville, NY 11747-3055 - Phone
- (631) 525-3646
- NPI assigned
- May 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 069056 | NY | Primary |
Addresses
Primary practice location
47 Villas Cir
Melville, NY 11747-3055
Mailing address
47 Villas Cir
Melville, NY 11747-3055
Phone (631) 525-3646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2022 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069056 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356559447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 VILLAS CIR",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117473055",
"telephone_number": "631-525-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 VILLAS CIR",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117473055",
"telephone_number": "631-525-3646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACHTEL",
"first_name": "SUSANNE",
"credential": "L.M.S.W. AND C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "069056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.