Susan Connelly Licensed Clinical Social Worker, P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

043911-1 Issued in NY

Legal business name

SUSAN CONNELLY LICENSED CLINICAL SOCIAL WORKER, P.C.

Practice address

515 E. Main St
Endicott, NY 13760-5023

Phone

(607) 427-4430

Fax

(607) 444-3319

NPI assigned

Aug 1, 2018

Organization subpart

No

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

Authorized official

Name

Susan L Connelly, LCSW

Title

Owner/Provider

Phone

(607) 427-4430

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1467930453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605023",
            "telephone_number": "607-427-4430",
            "fax_number": "607-444-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E. MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605023",
            "telephone_number": "607-427-4430",
            "fax_number": "607-444-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN CONNELLY LICENSED CLINICAL SOCIAL WORKER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "607-427-4430",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "043911-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Strong, LCSW-R
• Kristin Strong, MS ED
• Maliha Suleman, M.D.
• Sullivan Park Healthcare Center, Inc
• Christopher Jay Sullivan, D.C.
• Fatima Syed, DO
• Mary Sze-Tu, LCSW-R
• Kwei Ham Daniel Tan, D.O.
• Denise Tatich, M.S./CCC-SLP
• Abigail Joyce Terrill

• Clinical Social Worker in Endicott, NY
• Providers in Endicott, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.