Individual provider Active NPI

Susan Z Edelson, LCSW

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1669578803
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R31619 Issued in NY
Practice address
970 N Broadway
Suite 204
Yonkers, NY 10701-1309
Phone
(914) 478-1873
Fax
(914) 478-4436
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R31619 NY Primary

Addresses

Primary practice location

970 N Broadway
Suite 204
Yonkers, NY 10701-1309

Mailing address

53 Southlawn Ave
Dobbs Ferry, NY 10522-3519
Phone (914) 478-1873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R31619NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669578803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SOUTHLAWN AVE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105223519",
            "telephone_number": "914-478-1873",
            "fax_number": "914-478-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N BROADWAY",
            "address_2": "SUITE 204",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011309",
            "telephone_number": "914-478-1873",
            "fax_number": "914-478-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSON",
        "first_name": "SUSAN",
        "middle_name": "Z",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R31619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.