Suzanne Marie Perreault, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

071401-1 Issued in NY

Practice address

138 Campbell Ave
Ithaca, NY 14850-2059

Phone

(607) 351-1795

NPI assigned

Oct 12, 2006

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 1

Other names 1

• Suzanne Marie Cidell Former name

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1730278342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 CAMPBELL AVE",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502059",
            "telephone_number": "607-351-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 CAMPBELL AVE",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502059",
            "telephone_number": "607-351-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071401-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02876548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "CIDELL",
            "middle_name": "MARIE",
            "credential": "CSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Pena
• Susan Jean Penepent, RN
• Christopher Perez, MSW
• Judith Ann Perkins, RN
• Matthew Perkins
• Michele M Perry
• Michael Anthony Persoleo Jr., D.C.
• Kate Pesci
• Peter Schwartz, MD, PLLC
• Pamela Peterman, RN

• Clinical Social Worker in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.