Individual provider Active NPI

Kate D. Suskin, M.S.W.

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1487673562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0001037 Issued in VT
Practice address
112 Lake St
Burlington, VT 05401-5284
Phone
(802) 865-3450
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 089-0001037 VT Primary

Addresses

Primary practice location

112 Lake St
Burlington, VT 05401-5284

Mailing address

112 Lake St
Burlington, VT 05401-5284
Phone (802) 865-3450

Other identifiers 1

IdentifierTypeStateIssuer
1010841MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20040923000114 VT Practitioner - Clinical Social Worker 8123096500 Practice locations: Richmond, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 W Main St
Richmond, VT 05477-4479
Phone (802) 503-0083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0001037VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487673562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015284",
            "telephone_number": "802-865-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015284",
            "telephone_number": "802-865-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSKIN",
        "first_name": "KATE",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0001037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010841",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.