Individual provider Active NPI

Susan M Raymon, L.C.S.W.

  • Clinical Social Worker
  • Staten Island, NY
National Provider Identifier
1679793491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047617-1 Issued in NY
Practice address
669 Castleton Ave
Staten Island, NY 10301-2028
Phone
(718) 442-2225
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

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 R047617-1 NY Primary

Addresses

Primary practice location

669 Castleton Ave
Staten Island, NY 10301-2028

Mailing address

461 Harrison Ave
Highland Park, NJ 08904-2707
Phone (201) 572-6998

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
R047617-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679793491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 HARRISON AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042707",
            "telephone_number": "201-572-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMON",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

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.

Verify at the official NPI Registry.