Active NPI
Susan O'Rourke Ryan I, MSW
- Mental Health Counselor
- Concord, MA
National Provider Identifier
1679623540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 110575
- Practice address
- 9 Damonmill SQ
Suite 3-1a
Concord, MA 01742-2858 - Phone
- (978) 369-6669
- Fax
- (978) 369-6669
- NPI assigned
- Jan 11, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 110575 | MA | Primary |
Addresses
Primary practice location
9 Damonmill SQ
Suite 3-1a
Concord, MA 01742-2858
Mailing address
9 Damonmill SQ
Suite 3-1a
Concord, MA 01742-2858
Phone (978) 369-6669
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 21, 2024 through Oct 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110575 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679623540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 DAMONMILL SQ",
"address_2": "SUITE 3-1A",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422858",
"telephone_number": "978-369-6669",
"fax_number": "978-369-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 DAMONMILL SQ",
"address_2": "SUITE 3-1A",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422858",
"telephone_number": "978-369-6669",
"fax_number": "978-369-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "SUSAN",
"middle_name": "O'ROURKE",
"name_prefix": "Ms.",
"name_suffix": "I",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "110575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.