Individual provider Active NPI

Susan Clark Dauria, LCSW

  • Clinical Social Worker
  • Hackettstown, NJ
National Provider Identifier
1437265428
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC02831 Issued in NJ
Practice address
121 Shelley Dr
Suite 2F
Hackettstown, NJ 07840-2530
Phone
(908) 813-8820
Fax
(908) 813-2715
NPI assigned
Aug 22, 2006
Last updated
Dec 7, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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 SC02831 NJ Primary

Addresses

Primary practice location

121 Shelley Dr
Suite 2F
Hackettstown, NJ 07840-2530

Mailing address

121 Shelley Dr
Suite 2F
Hackettstown, NJ 07840-2530
Phone (908) 813-8820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • 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
I20050728000839 NJ Practitioner - Clinical Social Worker 1052347408 Practice locations: Hackettstown, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

121 Shelley Dr
Suite 2F
Hackettstown, NJ 07840-2530
Phone (908) 813-8820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC02831NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Longa Health Services ,LLC PastSince Mar 26, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1437265428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SHELLEY DR",
            "address_2": "SUITE 2F",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402530",
            "telephone_number": "908-813-8820",
            "fax_number": "908-813-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SHELLEY DR",
            "address_2": "SUITE 2F",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402530",
            "telephone_number": "908-813-8820",
            "fax_number": "908-813-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAURIA",
        "first_name": "SUSAN",
        "middle_name": "CLARK",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC02831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackettstown, NJ

Sources for this page

Verify at the official NPI Registry.