Individual provider Active NPI

Susan Ann Becker-Weidman, LCSW

  • Clinical Social Worker
  • Williamsville, NY
National Provider Identifier
1497852818
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R057251-1 Issued in NY
Practice address
5820 Main St Ste 406
Williamsville, NY 14221-5734
Phone
(716) 810-0790
Fax
(716) 636-6243
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

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 R057251-1 NY Primary

Addresses

Primary practice location

5820 Main St Ste 406
Williamsville, NY 14221-5734

Mailing address

5820 Main St Ste 406
Williamsville, NY 14221-5734
Phone (716) 810-0790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040823000795 NY Practitioner - Clinical Social Worker 9537132378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5820 Main St
Suite 406
Williamsville, NY 14221-5734
Phone (716) 636-6243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R057251-1NYMDClinical Social Worker
057251NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Becker-Weidman, CSW, P.C. Clinical CurrentSince Aug 30, 2015 Accepting new patients
Zali Psychology PC CurrentSince Jan 28, 2022 Accepting new patients

Locations

5820 Main St
Ste 406
Williamsville, NY 14221
Phone (716) 202-2210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497852818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 MAIN ST STE 406",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215734",
            "telephone_number": "716-810-0790",
            "fax_number": "716-636-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 MAIN ST STE 406",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215734",
            "telephone_number": "716-810-0790",
            "fax_number": "716-636-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER-WEIDMAN",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R057251-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.