Active NPI
Suzan J Mulligan, LCSW
- Clinical Social Worker
- Lincoln, NE
National Provider Identifier
1417010661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LMHP 881 LCSW 649
- Practice address
- 315 S 9TH St
Suite 15
Lincoln, NE 68508-2247 - Phone
- (402) 477-8278
- Fax
- (402) 477-8284
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LMHP 881 LCSW 649 | NE | Primary |
Addresses
Primary practice location
315 S 9TH St
Suite 15
Lincoln, NE 68508-2247
Mailing address
315 S 9TH St
Suite 15
Lincoln, NE 68508-2247
Phone (402) 477-8278
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8857 | Other | MIDLANDS CHOICE | |
| 82460 | Other | NE | BLUE CROSS OF NEBRASKA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 649 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| LMHP 881 LCSW 649 | NE | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417010661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 S 9TH ST",
"address_2": "SUITE 15",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685082247",
"telephone_number": "402-477-8278",
"fax_number": "402-477-8284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S 9TH ST",
"address_2": "SUITE 15",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685082247",
"telephone_number": "402-477-8278",
"fax_number": "402-477-8284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIGAN",
"first_name": "SUZAN",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "LMHP 881 LCSW 649",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "8857",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF NEBRASKA",
"identifier": "82460",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.