Individual provider Active NPI

Susan A. Levine, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1407925464
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000349 Issued in GA
Practice address
8097 Roswell Rd
BLDG B
Atlanta, GA 30350-6159
Phone
(770) 393-8806
Fax
(770) 393-8812
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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 000349 GA Primary

Addresses

Primary practice location

8097 Roswell Rd
BLDG B
Atlanta, GA 30350-6159

Mailing address

8097 Roswell Rd
BLDG B
Atlanta, GA 30350-6159
Phone (770) 393-8806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190118001551 GA Practitioner - Clinical Social Worker 8022354604 Practice locations: Roswell, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000349GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1407925464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8097 ROSWELL RD",
            "address_2": "BLDG B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303506159",
            "telephone_number": "770-393-8806",
            "fax_number": "770-393-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8097 ROSWELL RD",
            "address_2": "BLDG B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303506159",
            "telephone_number": "770-393-8806",
            "fax_number": "770-393-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "000349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.