Susan Bertilson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW606 Issued in WY

Practice address

1277 N 15TH St
Laramie, WY 82072-2343

Phone

(307) 742-6222

Fax

(307) 742-6414

NPI assigned

Mar 2, 2007

Last updated

Jul 9, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in OR

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, 2003

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287

  Clinical

  Medicare reassignment NPD
• Peacehealth Medical Group

  dba Nurse Midwifery Birth Center

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1639208291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-742-6222",
            "fax_number": "307-742-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-742-6222",
            "fax_number": "307-742-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTILSON",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coleen Marie Bernal
• Gissel Bernard-Molina, PPC
• Jeffrey Alan Bernard, R.PH.
• Andrea A. Berry, MHR
• Toinette M Berryhill, OTR
• Bestfit DME, Inc. (Bestfit DME WY)
• Abigail Bever
• Thomas A Bienz, MD
• Connie Bierman
• Molly Bierman, PMHNP, LICSW, RN

• Clinical Social Worker in Laramie, WY
• Providers in Laramie, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.