Active NPI
Susan J Kopka, MSW
- Clinical Social Worker
- Traverse City, MI
National Provider Identifier
1538458302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801085284
- Practice address
- 1200 W. 11TH St. Suite 113
Traverse City, MI 49684 - Phone
- (231) 883-2738
- NPI assigned
- Apr 1, 2011
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801085284 | MI | Primary |
Addresses
Primary practice location
1200 W. 11TH St. Suite 113
Traverse City, MI 49684
Mailing address
Box 155
10953 E Pobuda Rd
Omena, MI 49674
Phone (231) 883-2738
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 |
|---|---|---|---|
| 6801085284 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1538458302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 155",
"address_2": "10953 E POBUDA RD",
"city": "OMENA",
"state": "MI",
"postal_code": "49674",
"telephone_number": "231-883-2738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W. 11TH ST. SUITE 113",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49684",
"telephone_number": "231-883-2738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPKA",
"first_name": "SUSAN",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-01",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801085284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.