Individual provider Active NPI

Thelma Ann Suzuki, MSW

  • Clinical Social Worker
  • Newport Beach, CA
National Provider Identifier
1639284011
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS12509 Issued in CA
Practice address
1151 Dove St
Suite 295
Newport Beach, CA 92660-2840
Phone
(949) 851-9613
NPI assigned
Aug 19, 2006
Last updated
Oct 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCS12509 CA
Clinical Social Worker 1041C0700X LCS12509 CA Primary

Addresses

Primary practice location

1151 Dove St
Suite 295
Newport Beach, CA 92660-2840

Mailing address

1151 Dove St
Suite 295
Newport Beach, CA 92660-2840
Phone (949) 851-9613

Other identifiers 1

IdentifierTypeStateIssuer
CSW125090OtherCAMEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040413001140 CA Practitioner - Clinical Social Worker 0941294839 Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS12509CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Schneider, DO, Inc PastSince Sep 16, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1639284011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST",
            "address_2": "SUITE 295",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602840",
            "telephone_number": "949-851-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST",
            "address_2": "SUITE 295",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602840",
            "telephone_number": "949-851-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZUKI",
        "first_name": "THELMA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS12509",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS12509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "CSW125090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.