Individual provider Active NPI

Susan Diane Woloszyn, LCSWR

  • Clinical Social Worker
  • Cheektowaga, NY
National Provider Identifier
1760548846
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R039344-1 Issued in NY
Practice address
1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965
Phone
(716) 895-7167
Fax
(716) 332-4488
NPI assigned
Dec 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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 R039344-1 NY Primary

Addresses

Primary practice location

1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965

Mailing address

1526 Walden Ave
Suite 400
Cheektowaga, NY 14225-4965
Phone (716) 895-7167

Other identifiers 1

IdentifierTypeStateIssuer
00633532MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R039344-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1760548846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE",
            "address_2": "SUITE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254965",
            "telephone_number": "716-895-7167",
            "fax_number": "716-332-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE",
            "address_2": "SUITE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254965",
            "telephone_number": "716-895-7167",
            "fax_number": "716-332-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOSZYN",
        "first_name": "SUSAN",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-31",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R039344-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00633532",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheektowaga, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.