Susan Prince, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3033 Issued in TN

Practice address

5676 Stage Rd
Bartlett, TN 38134-4578

Phone

(901) 210-7463

Fax

(901) 347-1330

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1710008396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6946 AMBERLY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381196844",
            "telephone_number": "901-210-7463",
            "fax_number": "901-347-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5676 STAGE RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344578",
            "telephone_number": "901-210-7463",
            "fax_number": "901-347-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3920072",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4177584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lacey E Price, FNP-C
• Primehealth Medical Center, PC
• Emily Ann Promisel, PTA
• Nikita Pryor, FNP
• Psychiatry Group PLLC
• Robert Shane Pugsley, DC
• Sarah Jean Pugsley

• Clinical Social Worker in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.