Individual provider Active NPI

Susan Anne Chance, LCSW

  • Clinical Social Worker
  • Ormond Beach, FL
National Provider Identifier
1417254483
Registry record updated Feb 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 10152 Issued in FL
Practice address
555 W Granada Blvd
Suite B-12
Ormond Beach, FL 32174-9485
Phone
(386) 290-8269
NPI assigned
Feb 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 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 SW 10152 FL Primary

Addresses

Primary practice location

555 W Granada Blvd
Suite B-12
Ormond Beach, FL 32174-9485

Mailing address

6 Holly Fern Chase
Ormond Beach, FL 32174-2413
Phone (386) 290-8269

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

State licenses

LicenseStateTypeSpecialty
SW 10152FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1298764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298764800000",
    "number": "1417254483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HOLLY FERN CHASE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321742413",
            "telephone_number": "386-290-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W GRANADA BLVD",
            "address_2": "SUITE B-12",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749485",
            "telephone_number": "386-290-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-27",
        "last_updated": "2011-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 10152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2011; 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.