Individual provider Active NPI

Susan Doerflinger Sturdevant, LCSW

  • Clinical Social Worker
  • Mequon, WI
National Provider Identifier
1710092960
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6636-123 Issued in WI
Practice address
1001 W Glen Oaks LN Ste 105
Mequon, WI 53092-3369
Phone
(414) 258-8314
Fax
(414) 270-1031
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 6636-123 WI Primary

Addresses

Primary practice location

1001 W Glen Oaks LN Ste 105
Mequon, WI 53092-3369

Mailing address

1001 W Glen Oaks LN Ste 105
Mequon, WI 53092-3369
Phone (414) 258-8314

Other names 1

  • Susan M Doerflinger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040207000306 WI Practitioner - Clinical Social Worker 5496648826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1001 W Glen Oaks LN
Suite 105
Mequon, WI 53092-3369
Phone (414) 258-8314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6636-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Clinic Clinical CurrentSince Jan 1, 2011 Accepting new patients
Susan Doerflinger MSW LCSW Sac LLC Clinical CurrentSince May 17, 2021 Accepting new patients
Aurora Sinai Medical Center, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Psychiatric Hospital, Inc. Past Accepting new patients

Locations

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

2524 E Webster Pl
Ste 203
Milwaukee, WI 53211
Phone (414) 964-9200

7845 Harwood Ave
Wauwatosa, WI 53213
Phone (262) 492-1090

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1710092960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W GLEN OAKS LN STE 105",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923369",
            "telephone_number": "414-258-8314",
            "fax_number": "414-270-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W GLEN OAKS LN STE 105",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923369",
            "telephone_number": "414-258-8314",
            "fax_number": "414-270-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDEVANT",
        "first_name": "SUSAN",
        "middle_name": "DOERFLINGER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6636-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "DOERFLINGER",
            "middle_name": "M",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.