Individual provider Active NPI

Susan Kay Dudek, MSW, MA

  • Clinical Social Worker
  • Northampton, MA
National Provider Identifier
1396824728
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020818 Issued in MA
Practice address
43 Center St Ste 305
Northampton, MA 01060-3062
Phone
(413) 221-6433
NPI assigned
Nov 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 252 MA
Clinical Social Worker 1041C0700X 1020818 MA Primary

Addresses

Primary practice location

43 Center St Ste 305
Northampton, MA 01060-3062

Mailing address

11 Linden St
Northampton, MA 01060-3207
Phone (413) 221-6433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20051013000708 MA Practitioner - Clinical Social Worker 6608891007 Practice locations: Northampton, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1020818MAMDClinical Social Worker
252MAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1396824728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LINDEN ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603207",
            "telephone_number": "413-221-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CENTER ST STE 305",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603062",
            "telephone_number": "413-221-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MSW, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-05",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "252",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.