Susan Support Services

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SUSAN SUPPORT SERVICES

Practice address

961 Coconut Dr
Fort Myers, FL 33903-4201

Phone

(239) 362-5802

NPI assigned

Oct 28, 2021

Organization subpart

No

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

Authorized official

Name

Susan Rachel GoinsNPI 1720741820

Title

Waiver Support Coordinator

Phone

(239) 362-5802

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Rachel Goins, SUPPORT COORDINATOR

  • Social Worker
  • North Fort Myers, FL
  • NPI 1720741820
  NPD Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1700540481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 COCONUT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339034201",
            "telephone_number": "239-362-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 COCONUT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339034201",
            "telephone_number": "239-362-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "GOINS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "RACHEL",
        "authorized_official_title_or_position": "WAIVER SUPPORT COORDINATOR",
        "authorized_official_telephone_number": "239-362-5802"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgical Specialists of Southwest Florida P.a.
• Surgical Spine Associates, LLC
• Surgicare Center
• Surgicare Center LLC
• Susan R King PSYD PA
• Susana Izquierdo Therapy Solutions, LLC
• Keith S. Susko, M.D.
• Morgan Elise Sutherland
• Lucinda Sutton
• Inesa Sviridova, PA

• Developmental Disabilities Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.