Individual provider Active NPI

Susan L Brisby, LCSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1376774109
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L5380 Issued in OR
Practice address
Puget Sound Veterans Hospital
1660 S. Columbian Way
Seattle, WA 98108
Phone
(206) 518-1593
Fax
(360) 395-2939
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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 L5380 OR Primary

Addresses

Primary practice location

Puget Sound Veterans Hospital
1660 S. Columbian Way
Seattle, WA 98108

Mailing address

23522 Jordan Rd
Arlington, WA 98223-9579
Phone (931) 220-2499

Other identifiers 1

IdentifierTypeStateIssuer
L5380OtherORSW CLINICAL LICENSURE

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
L5380ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1376774109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23522 JORDAN RD",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982239579",
            "telephone_number": "931-220-2499",
            "fax_number": "931-220-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PUGET SOUND VETERANS HOSPITAL",
            "address_2": "1660 S. COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98108",
            "telephone_number": "206-518-1593",
            "fax_number": "360-395-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISBY",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SW CLINICAL LICENSURE",
            "identifier": "L5380",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.