Active NPI
Susan M Flaherty, LCSW
- Clinical Social Worker
- Wantagh, NY
National Provider Identifier
1619008000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR020810-1
- Practice address
- 3375 Park Ave
Ste. 2004
Wantagh, NY 11793-3733 - Phone
- (516) 785-8600
- Fax
- (516) 785-8600
- NPI assigned
- Mar 8, 2007
- 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 | PR020810-1 | NY | Primary |
Addresses
Primary practice location
3375 Park Ave
Ste. 2004
Wantagh, NY 11793-3733
Mailing address
3375 Park Ave
Ste. 2004
Wantagh, NY 11793-3733
Phone (516) 785-8600
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00151186 | Other | NY | GHI PROVIDER ID |
| 020810 | Other | NY | HIP PROVIDER ID |
| 64499 | Other | NY | VYTRA HEALTH PLAN PROVIDE |
| 110480 | Other | NY | VALUE OPTIONS PROVIDER ID |
| 7442 | Other | NY | HORIZON HEALTHCARE ID |
| 10509395 | Other | NY | CAQH PROVIDER ID |
| 4316325 | Other | NY | AETNA PROVIDER ID |
| 55247 | Other | NY | HIP PAYOR ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR020810-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619008000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3375 PARK AVE",
"address_2": "STE. 2004",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933733",
"telephone_number": "516-785-8600",
"fax_number": "516-785-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3375 PARK AVE",
"address_2": "STE. 2004",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933733",
"telephone_number": "516-785-8600",
"fax_number": "516-785-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAHERTY",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR020810-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER ID",
"identifier": "00151186",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP PROVIDER ID",
"identifier": "020810",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA HEALTH PLAN PROVIDE",
"identifier": "64499",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER ID",
"identifier": "110480",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON HEALTHCARE ID",
"identifier": "7442",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID",
"identifier": "10509395",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER ID",
"identifier": "4316325",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIP PAYOR ID",
"identifier": "55247",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.