Individual provider Active NPI

Susan Landau, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1730420522
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012866 Issued in PA
Practice address
3343 W Penn St
Philadelphia, PA 19129-1407
Phone
(267) 250-5711
NPI assigned
Mar 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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 CW012866 PA Primary

Addresses

Primary practice location

3343 W Penn St
Philadelphia, PA 19129-1407

Mailing address

3343 W Penn St
Philadelphia, PA 19129-1407
Phone (267) 250-5711

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
CW012866PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1730420522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 W PENN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291407",
            "telephone_number": "267-250-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 W PENN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291407",
            "telephone_number": "267-250-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAU",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.