Individual provider Active NPI

Susan A. Onderwyzer, LICSW

  • Clinical Social Worker
  • Exeter, NH
National Provider Identifier
1679800957
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2117 Issued in NH
Practice address
24 Front St Ste 100
Exeter, NH 03833-2727
Phone
(603) 883-0005
NPI assigned
Nov 8, 2009
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000180 VT
Clinical Social Worker 1041C0700X 089-0000155 VT
Clinical Social Worker 1041C0700X 2117 NH Primary

Addresses

Primary practice location

24 Front St Ste 100
Exeter, NH 03833-2727

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other practice location 1

15 Old Rollinsford Rd Ste 302
Dover, NH 03820-2819
Phone (603) 742-9200

Other practice location 2

34 Patchen Rd
South Burlington, VT 05403-5704
Phone (802) 658-4208

Other practice location 3

77 Gilcreast Rd Ste 3000
Londonderry, NH 03053-3563
Phone (603) 883-0005

Other practice location 4

100 Eileen Dondero Foley Ave Ste 302
Portsmouth, NH 03801-4597
Phone (603) 883-0005

Other identifiers 1

IdentifierTypeStateIssuer
3118595MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610000979 NH Practitioner - Clinical Social Worker 3476523622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000180VTMDAddiction (Substance Use Disorder) Counselor
089-0000155VTMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1257638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1679800957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRONT ST STE 100",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332727",
            "telephone_number": "603-883-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Old Rollinsford Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038202819",
            "country_code": "US",
            "telephone_number": "603-742-9200",
            "fax_number": "603-742-4605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 Patchen Rd",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054035704",
            "country_code": "US",
            "telephone_number": "802-658-4208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Gilcreast Rd Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Londonderry",
            "state": "NH",
            "postal_code": "030533563",
            "country_code": "US",
            "telephone_number": "603-883-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Eileen Dondero Foley Ave Ste 302",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038014597",
            "country_code": "US",
            "telephone_number": "603-883-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONDERWYZER",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-08",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000180",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000155",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3118595",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.