Individual provider Active NPI

Susan M. Carson, L.I.S.W.

  • Clinical Social Worker
  • Powell, OH
National Provider Identifier
1710074810
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0005655 Issued in OH
Practice address
97 S Liberty St
Powell, OH 43065-9301
Phone
(614) 781-1340
Fax
(614) 841-1567
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
Yes

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 I-0005655 OH Primary

Addresses

Primary practice location

97 S Liberty St
Powell, OH 43065-9301

Mailing address

97 S Liberty St
Powell, OH 43065-9301
Phone (614) 781-1340

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
I-0005655OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710074810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 S LIBERTY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659301",
            "telephone_number": "614-781-1340",
            "fax_number": "614-841-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 S LIBERTY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430659301",
            "telephone_number": "614-781-1340",
            "fax_number": "614-841-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0005655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

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.