Individual provider Active NPI

Susana Maria Montesinos, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1740513142
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61381020 Issued in WA
Practice address
352 7TH Ave RM 705
New York, NY 10001-5889
Phone
(754) 300-6760
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 084963-1 NY
Social Worker 104100000X SW14160 FL
Clinical Social Worker 1041C0700X 119136 MA
Clinical Social Worker 1041C0700X LW61381020 WA Primary

Addresses

Primary practice location

352 7TH Ave RM 705
New York, NY 10001-5889

Mailing address

PO Box 1832
New York, NY 10159-1832
Phone (646) 470-3676

Other practice location 1

2440 Coral Way
Coral Gables, FL 33145-3410
Phone (754) 300-6760

Other practice location 2

3 Summer St
Andover, MA 01810-3619
Phone (754) 300-6760

Other practice location 3

14494 W Baseline Rd
Quincy, WA 98848-9597
Phone (754) 300-6760

Other identifiers 1

IdentifierTypeStateIssuer
05330281MedicaidNY

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
I20181113003134 NY Practitioner - Clinical Social Worker 3577817329 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14160FLMDSocial Worker
084963-1NYMDSocial Worker
119136MAMDClinical Social Worker
LW61381020WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Montepuente Clinical PastSince Sep 4, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1740513142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101591832",
            "telephone_number": "646-470-3676",
            "fax_number": "617-424-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 7TH AVE RM 705",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015889",
            "telephone_number": "754-300-6760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2440 Coral Way",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331453410",
            "country_code": "US",
            "telephone_number": "754-300-6760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Summer St",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MA",
            "postal_code": "018103619",
            "country_code": "US",
            "telephone_number": "754-300-6760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14494 W Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "WA",
            "postal_code": "988489597",
            "country_code": "US",
            "telephone_number": "754-300-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTESINOS",
        "first_name": "SUSANA",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084963-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW14160",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119136",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61381020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05330281",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.