Active NPI
Susan O'Connor, LICSW
- Social Worker
- Lawrence, MA
National Provider Identifier
1487132833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 120827
- Practice address
- 439 S Union St
Lawrence, MA 01843-2837 - Phone
- (781) 469-0631
- NPI assigned
- Jul 29, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 120827 | MA | Primary |
Addresses
Primary practice location
439 S Union St
Lawrence, MA 01843-2837
Mailing address
439 S Union St
Lawrence, MA 01843-2837
Phone (781) 469-0631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4563 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 120827 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532822400000",
"number": "1487132833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 S UNION ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018432837",
"telephone_number": "781-469-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 S UNION ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018432837",
"telephone_number": "781-469-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "SUSAN",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-29",
"last_updated": "2018-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "120827",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4563",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.