Individual provider Active NPI

Susan Elizabeth Hoenninger, M.S., LMHC

  • Mental Health Counselor
  • Watertown, NY
National Provider Identifier
1417097114
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000266-1 Issued in NY
Practice address
482 Black River Pkwy
Watertown, NY 13601-2416
Phone
(315) 782-1777
NPI assigned
Feb 8, 2007
Reactivated
Aug 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000266-1 NY Primary

Addresses

Primary practice location

482 Black River Pkwy
Watertown, NY 13601-2416

Mailing address

482 Black River Pkwy
Watertown, NY 13601-2416

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000266-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Wellness and Recovery, Inc PastSince Aug 4, 2024 Accepting new patients
North Country Transitional Living Services, Inc PastSince Jul 1, 2019 Accepting new patients

Organizations & group practices 2

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1417097114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 BLACK RIVER PKWY",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 BLACK RIVER PKWY",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012416",
            "telephone_number": "315-782-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOENNINGER",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.S., LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2016-12-01",
        "deactivation_date": "2015-11-06",
        "reactivation_date": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000266-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.