Susan Crockett
Individual provider Active NPI Case Manager/Care Coordinator · Langdon, ND
NPI 1487072807 · NPPES record last updated Apr 2, 2014
Key facts
- NPI
- 1487072807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 1274 (ND)
- Practice address
- 324 7TH Ave
Langdon, ND 58249-2516 - Phone
- (701) 256-2175
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1274 | ND | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cavalier County Social Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 1274 | ND | Yes |
Addresses
Primary practice location
324 7TH Ave
Langdon, ND 58249-2516
Mailing address
523 18TH Ave
Langdon, ND 58249-1708
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79217 | Medicaid | ND |
Other providers in Langdon, ND
- Cavalier County Memorial Hospital Association
- Cavalier County Memorial Hospital Association
- Cavalier County Senior Meals & Services
- Cavalier County Social Services
- Michele Marie Christianson
- Julie Davis
- Richard H Eklof
- Megan Joann Hursman
- Kari Irvis
- K Group PC
All providers in Langdon, ND · Case Manager/Care Coordinator in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.