Susan Joan Donnelly, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SC00206800 Issued in NJ

Practice address

115 Pine Street
Ridgewood, NJ 07450

Phone

(201) 447-0364

Fax

(201) 445-2354

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Susan Joan Donnelly Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1669588968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PINE ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501619",
            "telephone_number": "201-447-0364",
            "fax_number": "201-445-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PINE STREET",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-447-0364",
            "fax_number": "201-445-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "SUSAN",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC00206800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALPRACTICE INSURANCE",
            "identifier": "SWL4705997",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "44SC00206800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "DONNELLY",
            "middle_name": "JOAN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ismar Dizdarevic, M.D.
• Igor Dmytrienko, MD
• Keith F Dockery, M.D.
• Kristin Doherty, LPC
• Melissa L. Donahue
• Margaret T Doty, LSW
• Michelle K Doughty, MSW, LCSW
• Dr Levinstein Therapy Group Inc
• Dr. James R. Cowan, Jr. M.D. P.a.
• Marc Max Dreier, MD

• Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.