Fay Susskind, PSY.D., M.S., LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SC00766900 Issued in NJ

Practice address

3 Fairfield Ave
Second Floor
West Caldwell, NJ 07006-7629

Phone

(973) 228-9008

NPI assigned

Apr 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

• Dr. Fay Tassoff Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730308107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WESTOVER AVE",
            "address_2": "APARTMERT C-5",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070064824",
            "telephone_number": "973-228-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FAIRFIELD AVE",
            "address_2": "SECOND FLOOR",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067629",
            "telephone_number": "973-228-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSKIND",
        "first_name": "FAY",
        "name_prefix": "Dr.",
        "credential": "PSY.D., M.S., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SC00766900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CREDENTIALING SERVICE",
            "identifier": "CAQH#11690655",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAY",
            "last_name": "TASSOFF",
            "prefix": "DR.",
            "credential": "PSY.D., M.S., LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in West Caldwell, NJ
• Providers in West Caldwell, NJ by specialty
• Social Worker in New Jersey

• 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.