Active NPI
Susan C Brown, LMSW
- Social Worker
- Twin Falls, ID
National Provider Identifier
1477837698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 30820
- Practice address
- 414 Shoup Ave W
Sutie B
Twin Falls, ID 83301-5042 - Phone
- (208) 814-9100
- NPI assigned
- Oct 6, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 30820 | ID | Primary |
Addresses
Primary practice location
414 Shoup Ave W
Sutie B
Twin Falls, ID 83301-5042
Mailing address
1373 Fillmore St
Twin Falls, ID 83301-3392
Phone (208) 814-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477837698 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
101 Empty Saddle TRL
Suite 120
Hailey, ID 83333-8437
Phone (208) 928-7507
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30820 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways of Idaho, LLC | Current | Accepting new patients | |
| Carbonate Recovery Center, Inc | Past | Accepting new patients |
Locations
204 10th Ave S
Nampa, ID 83651
Phone (208) 461-6523
10304 Spotsylvania Ave
Ste 300
Fredericksburg, VA 22408
Phone (540) 710-6085
Organizations & group practices 3
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.
-
- Clinical Social Worker
- Hailey, ID
- NPI 1174010573
-
- Community/Behavioral Health Agency
- Boise, ID
- NPI 1326466988
-
- Addiction (Substance Use Disorder) Counselor
- Hailey, ID
- NPI 1225884216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1477837698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1373 FILLMORE ST",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013392",
"telephone_number": "208-814-9100",
"fax_number": "208-814-9903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 SHOUP AVE W",
"address_2": "SUTIE B",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015042",
"telephone_number": "208-814-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SUSAN",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-06",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "30820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477837698",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.