Active NPI
Susan J Bailey, LADC I
- Addiction (Substance Use Disorder) Counselor
- North Conway, NH
National Provider Identifier
1740430610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 0570
- Practice address
- Grove Street
15 Grove Street
North Conway, NH 03860 - Phone
- (603) 869-2210
- NPI assigned
- Sep 26, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 809 | MA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0570 | NH | Primary |
Addresses
Primary practice location
Grove Street
15 Grove Street
North Conway, NH 03860
Mailing address
PO Box 717
Bethlehem, NH 03574-0717
Phone (603) 869-2210
Other practice location 1
2617 White Mountain Hwy
North Conway, NH 03860-5120
Phone (603) 356-0220
Other practice location 2
448 White Mountain Hwy
Tamworth, NH 03886-4626
Phone (603) 869-2210 ext. 16
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
| License | State | Type | Specialty |
|---|---|---|---|
| 809 | MA | MD | Occupational Therapy Assistant |
| 0570 | NH | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1740430610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 717",
"city": "BETHLEHEM",
"state": "NH",
"postal_code": "035740717",
"telephone_number": "603-869-2210",
"fax_number": "603-869-2355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GROVE STREET",
"address_2": "15 GROVE STREET",
"city": "NORTH CONWAY",
"state": "NH",
"postal_code": "03860",
"telephone_number": "603-869-2210"
}
],
"practiceLocations": [
{
"address_1": "2617 White Mountain Hwy",
"address_purpose": "LOCATION",
"city": "North Conway",
"state": "NH",
"postal_code": "038605120",
"country_code": "US",
"telephone_number": "603-356-0220",
"fax_number": "603-356-0021",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "448 White Mountain Hwy",
"address_purpose": "LOCATION",
"city": "Tamworth",
"state": "NH",
"postal_code": "038864626",
"country_code": "US",
"telephone_number": "603-869-2210 x16",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAILEY",
"first_name": "SUSAN",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "LADC I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-26",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "809",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NH",
"license": "0570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Conway, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.