Active NPI
Suzanne Marie Odom, LMSW
- Social Worker
- Albany, NY
National Provider Identifier
1649817628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 09144651
- Practice address
- 1525 Western Ave Ste 4
Albany, NY 12203-3537 - Phone
- (518) 289-0426
- NPI assigned
- Dec 9, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 09144651 | NY | Primary |
Addresses
Primary practice location
1525 Western Ave Ste 4
Albany, NY 12203-3537
Mailing address
1006 Lemoyne Ave
Syracuse, NY 13208-1211
Phone (315) 200-2024
Other practice location 1
417 E German St.
Herkimer, NY 13350
Other practice location 2
1525 Western Ave Ste 1
Albany, NY 12203-3537
Phone (518) 289-0426
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.drncornerstone.com | Direct |
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 |
|---|---|---|---|
| 09144651 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1649817628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 LEMOYNE AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132081211",
"telephone_number": "315-200-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 WESTERN AVE STE 4",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033537",
"telephone_number": "518-289-0426"
}
],
"practiceLocations": [
{
"address_1": "417 E German St.",
"address_purpose": "LOCATION",
"city": "Herkimer",
"state": "NY",
"postal_code": "13350",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1525 Western Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122033537",
"country_code": "US",
"telephone_number": "518-289-0426",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ODOM",
"first_name": "SUZANNE",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-09",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "09144651",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.drncornerstone.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "417 E German St.",
"city": "Herkimer",
"state": "NY",
"country_code": "US",
"postal_code": "13350",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.