Active NPI
Susan Alexandra Klupchak, LCSW
- Clinical Social Worker
- Waltham, MA
National Provider Identifier
1598212771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 221808
- Practice address
- 296 Newton St
Suite 150
Waltham, MA 02453-0423 - Phone
- (414) 688-5494
- NPI assigned
- Sep 6, 2016
- Last updated
- Sep 6, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 221808 | MA | Primary |
Addresses
Primary practice location
296 Newton St
Suite 150
Waltham, MA 02453-0423
Mailing address
296 Newton St
Suite 150
Waltham, MA 02453-0423
Phone (414) 688-5494
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 |
|---|---|---|---|
| 221808 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473120000000",
"number": "1598212771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "296 NEWTON ST",
"address_2": "SUITE 150",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024530423",
"telephone_number": "414-688-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 NEWTON ST",
"address_2": "SUITE 150",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024530423",
"telephone_number": "414-688-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUPCHAK",
"first_name": "SUSAN",
"middle_name": "ALEXANDRA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-06",
"last_updated": "2016-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "221808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.