Individual provider Active NPI

Susanne Halliday, MSW, LICSW

  • Clinical Social Worker
  • Springfield, MA
National Provider Identifier
1699862607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110261 Issued in MA
Practice address
503 State St
Springfield, MA 01109-4101
Phone
(413) 733-6661
Fax
(413) 733-7841
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 110261 MA Primary

Addresses

Primary practice location

503 State St
Springfield, MA 01109-4101

Mailing address

134 Ferncliff Ave
Springfield, MA 01119-2504
Phone (413) 783-9771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20051012000872 MA Practitioner - Clinical Social Worker 4981629557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Health Network IncGroup PAC ID 3072596360, 146 clinicians

Practice addresses (Care Compare)

40 Bobala Rd
Holyoke, MA 01040-9632
Phone (413) 536-5473

417 Liberty St
Springfield, MA 01104-3736
Phone (413) 736-3668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network Inc CurrentSince Sep 4, 2016 Accepting new patients
Behavioral Health Network, Inc CurrentSince Sep 4, 2016 Accepting new patients
Massachusetts Society for the Prevention of Cruelty to Children PastSince Jan 1, 2008 Accepting new patients
Mspcc Mass Society of Prevention of Crualty to Children Past Accepting new patients

Locations

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

110 Maple St
Springfield, MA 01105
Phone (413) 846-4300

503 State St
Springfield, MA 01109
Phone (413) 733-6661

Organizations & group practices 4

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699862607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 FERNCLIFF AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011192504",
            "telephone_number": "413-783-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011094101",
            "telephone_number": "413-733-6661",
            "fax_number": "413-733-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIDAY",
        "first_name": "SUSANNE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.