Susan A White, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-011526 Issued in IL

Practice address

800 Main St
Ste 11 Lower Level
Antioch, IL 60002-1542

Phone

(224) 577-5022

Fax

(847) 395-9551

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lifeskills Center, LTD

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1063623940
  Medicare reassignment NPD Authorized official
• Michael L Klestinski & Associates, P.C.

  • Social Worker
  • Libertyville, IL
  • NPI 1477638948
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1508919812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "address_2": "STE 11 LOWER LEVEL",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021542",
            "telephone_number": "224-577-5022",
            "fax_number": "847-395-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "address_2": "STE 11 LOWER LEVEL",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021542",
            "telephone_number": "224-577-5022",
            "fax_number": "847-395-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-011526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11722321",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick M Walker
• Rebecca Walker, COTA/L
• Walmart Inc.
• Abigail A Waters, COTA/L
• Daniel F Werner
• Julie Williams, PA-C
• Mary Theresa Wirth, O.T.R.
• Stanley Jerome Witkiewicz, DDS
• Brandon B Wood, DMD
• Lonn Truong Yang, O.D.

• Clinical Social Worker in Antioch, IL
• Providers in Antioch, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.

Verify at the official NPI Registry.