Individual provider Active NPI

Susan Marie Rheaume, LICSW

  • Mental Health Counselor
  • Gloucester, MA
National Provider Identifier
1548378987
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
111258 Issued in MA
Practice address
80 Prospect St
Unit 16
Gloucester, MA 01930-3748
Phone
(978) 758-8115
NPI assigned
Aug 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 111258 MA Primary

Addresses

Primary practice location

80 Prospect St
Unit 16
Gloucester, MA 01930-3748

Mailing address

5 Parker St
Rockport, MA 01966-1623
Phone (978) 546-2396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050819000587 MA Practitioner - Clinical Social Worker 8527098482 Practice locations: Gloucester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

80 Prospect St
Unit 16
Gloucester, MA 01930-3748
Phone (978) 758-8115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111258MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Hospital Corporation PastSince Oct 23, 2002 Accepting new patients

Organizations & group practices 1

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": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1548378987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PARKER ST",
            "city": "ROCKPORT",
            "state": "MA",
            "postal_code": "019661623",
            "telephone_number": "978-546-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PROSPECT ST",
            "address_2": "UNIT 16",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019303748",
            "telephone_number": "978-758-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEAUME",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "111258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.