Active NPI
Susan G Eckberg, MSW
- Clinical Social Worker
- Bolling Afb, DC
National Provider Identifier
1669566261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW940
- Practice address
- 238 Brookley Avenue
BLDG 1300, Ste 259
Bolling Afb, DC 20032-0101 - Phone
- (202) 404-6502
- Fax
- (202) 404-2911
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- 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 | LCSW940 | ID | Primary |
Addresses
Primary practice location
238 Brookley Avenue
BLDG 1300, Ste 259
Bolling Afb, DC 20032-0101
Mailing address
P.O. Box 19079
Alexandria, VA 22320
Phone (703) 518-8388
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 |
|---|---|---|---|
| LCSW940 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669566261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 19079",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22320",
"telephone_number": "703-518-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 BROOKLEY AVENUE",
"address_2": "BLDG 1300, STE 259",
"city": "BOLLING AFB",
"state": "DC",
"postal_code": "200320101",
"telephone_number": "202-404-6502",
"fax_number": "202-404-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKBERG",
"first_name": "SUSAN",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolling Afb, DC
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.