Jacqueline Maloch Sudderth, MSW,LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P021089 Issued in NC

Practice address

77 Central Ave Ste C
Asheville, NC 28801-2451

Phone

(828) 393-0902

NPI assigned

Jan 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ellie of Avl Central, PLLC

  • Marriage & Family Therapist
  • Asheville, NC
  • NPI 1194506204
  NPD
• Real Recovery of Asheville, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Asheville, NC
  • NPI 1417318874
  NPD (past)

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1376183632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CENTRAL AVE STE C",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288012451",
            "telephone_number": "828-393-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CENTRAL AVE STE C",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288012451",
            "telephone_number": "828-393-0902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Tunnel Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288051869",
            "country_code": "US",
            "telephone_number": "828-423-2669",
            "fax_number": "828-774-5726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDDERTH",
        "first_name": "JACQUELINE",
        "middle_name": "MALOCH",
        "credential": "MSW,LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-26098",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Stultz, LCSW
• Patricia Ann Stump, LPC
• Charles Douglas Stutesman, PA-C
• Richard Suchan, DPT
• Rachel M Suddarth, LPC
• Kimberly A Suess, P.A.
• Christopher Suhr, M.D.
• Gwyneth Caroline Magno Suico, PT
• Romeesa Sulkowski, RN
• Carolyn Nicole Sullens, D.D.S. P.A.

• Clinical Social Worker in Asheville, NC
• Providers in Asheville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.