Individual provider Active NPI

Suzanne G. Olesker, LCSW-C

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1760408140
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08015 Issued in MD
Practice address
120 Sister Pierre Dr Ste 403
Towson, MD 21204-7536
Phone
(410) 823-6408
Fax
(443) 279-0537
NPI assigned
Jul 15, 2006
Last updated
Jan 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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 08015 MD Primary

Addresses

Primary practice location

120 Sister Pierre Dr Ste 403
Towson, MD 21204-7536

Mailing address

120 Sister Pierre Dr Ste 403
Towson, MD 21204-7536
Phone (410) 823-6408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20050415000413 MD Practitioner - Clinical Social Worker 4082651559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
True Life ChangeGroup PAC ID 1759774128, 4 clinicians

Practice addresses (Care Compare)

5100 Buckeystown Pike
Suite 250
Frederick, MD 21704-8344
Phone (410) 417-7556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08015MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
True Life Change CurrentSince Dec 29, 2021 Accepting new patients
Psych Associates of Maryland LLC CurrentSince Mar 1, 2012 Accepting new patients
Psych Associates Care, LLC Past Accepting new patients

Locations

5100 Buckeystown Pike
Frederick, MD 21704
Phone (301) 321-8245

5100 Buckeystown Pike
Ste 250
Frederick, MD 21704
Phone (301) 321-8245

2331 York Rd
Ste 100
Timonium, MD 21093

120 Sister Pierre Dr
Ste 403
Towson, MD 21204
Phone 4108236408104

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1760408140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 403",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536",
            "telephone_number": "410-823-6408",
            "fax_number": "443-279-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR STE 403",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047536",
            "telephone_number": "410-823-6408",
            "fax_number": "443-279-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLESKER",
        "first_name": "SUZANNE",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "08015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.