Individual provider Active NPI

Susan Letteney, DSW, LCSW

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1710167044
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR038764-1 Issued in NY
Practice address
15 Canterbury Rd Ste A3
Great Neck, NY 11021-2615
Phone
(516) 457-6529
NPI assigned
Nov 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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 PR038764-1 NY Primary

Addresses

Primary practice location

15 Canterbury Rd Ste A3
Great Neck, NY 11021-2615

Mailing address

15 Canterbury Rd Ste A3
Great Neck, NY 11021-2615
Phone (516) 457-6529

Other practice location 1

460 W 24th St Apt 4F
New York, NY 10011-1364
Phone (212) 727-7591

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PR038764-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1194048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1710167044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CANTERBURY RD STE A3",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212615",
            "telephone_number": "516-457-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CANTERBURY RD STE A3",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212615",
            "telephone_number": "516-457-6529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 W 24th St Apt 4F",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100111364",
            "country_code": "US",
            "telephone_number": "212-727-7591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LETTENEY",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-03",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR038764-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.