Individual provider Active NPI

Rebecca Suschitzky, LCSW

  • Clinical Social Worker
  • Somerville, MA
National Provider Identifier
1669619177
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
212484 Issued in MA
Practice address
61 Medford St
Somerville, MA 02143-3421
Phone
(617) 629-3919
Fax
(617) 629-4644
NPI assigned
Jan 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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 212484 MA Primary

Addresses

Primary practice location

61 Medford St
Somerville, MA 02143-3421

Mailing address

10 Ridgeway Ave
Needham, MA 02492-4220
Phone (617) 868-6116

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

LicenseStateTypeSpecialty
212484MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1669619177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 RIDGEWAY AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024924220",
            "telephone_number": "617-868-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEDFORD ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433421",
            "telephone_number": "617-629-3919",
            "fax_number": "617-629-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSCHITZKY",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "212484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.