Individual provider Active NPI

Susan Eve Sukenik, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1740370279
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R029170 Issued in NY
Practice address
640 19TH St
Brooklyn, NY 11218-1048
Phone
(718) 871-8991
Fax
(718) 871-8991
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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 R029170 NY Primary

Addresses

Primary practice location

640 19TH St
Brooklyn, NY 11218-1048

Mailing address

640 19TH St
Brooklyn, NY 11218-1048
Phone (718) 871-8991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170130000934 NY Practitioner - Clinical Social Worker 1557460177 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

640 19TH St
Brooklyn, NY 11218-1048
Phone (718) 871-8991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R029170NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1740370279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181048",
            "telephone_number": "718-871-8991",
            "fax_number": "718-871-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181048",
            "telephone_number": "718-871-8991",
            "fax_number": "718-871-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKENIK",
        "first_name": "SUSAN",
        "middle_name": "EVE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R029170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.