Individual provider Active NPI

Susanna Marie Lozano, LISW-S

  • Clinical Social Worker
  • Hamilton, OH
National Provider Identifier
1386695922
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 0010203 - S Issued in OH
Practice address
1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930
Phone
(513) 795-7557
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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 I. 0010203 - S OH Primary

Addresses

Primary practice location

1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930

Mailing address

820 S Martin Luther King Jr Blvd
Hamilton, OH 45011-3216
Phone (513) 887-8500

Other practice location 1

820 S Martin Luther King Jr Blvd
Hamilton, OH 45011-3216
Phone (513) 887-8500

Other names 1

  • Susanna Marie Lozano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130708000516 OH Practitioner - Clinical Social Worker 6204813736 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I. 0010203 - SOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry & Wellness, LLC CurrentSince Jun 2, 2024 Accepting new patients
Community Behavioral Health Inc. Past Accepting new patients

Locations

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1386695922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S MARTIN LUTHER KING JR BLVD",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450113216",
            "telephone_number": "513-887-8500",
            "fax_number": "513-737-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 S Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450113216",
            "country_code": "US",
            "telephone_number": "513-887-8500",
            "fax_number": "513-737-8197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOZANO",
        "first_name": "SUSANNA",
        "middle_name": "MARIE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 0010203 - S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "LOZANO",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.