Individual provider Active NPI

Susan Kay Doig, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1396188942
Registry record updated Apr 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009429 Issued in IL
Practice address
1510 Dempster St
Apt 2
Evanston, IL 60202-1117
Phone
(773) 407-4622
NPI assigned
Apr 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2013

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 149009429 IL Primary

Addresses

Primary practice location

1510 Dempster St
Apt 2
Evanston, IL 60202-1117

Mailing address

1510 Dempster St
Apt 2
Evanston, IL 60202-1117
Phone (773) 407-4622

Other identifiers 1

IdentifierTypeStateIssuer
149009429OtherILSTATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149009429ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1365897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365897600000",
    "number": "1396188942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 DEMPSTER ST",
            "address_2": "APT 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021117",
            "telephone_number": "773-407-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 DEMPSTER ST",
            "address_2": "APT 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021117",
            "telephone_number": "773-407-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOIG",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-14",
        "last_updated": "2013-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "149009429",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2013; 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.