Individual provider Active NPI

Susan E Shouse, CSW

  • Clinical Social Worker
  • Clinton, MI
National Provider Identifier
1780654277
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801072025 Issued in MI
Practice address
208 Clark St
Clinton, MI 49236-9561
Phone
(517) 673-4476
Fax
(734) 586-7328
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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 6801072025 MI Primary

Addresses

Primary practice location

208 Clark St
Clinton, MI 49236-9561

Mailing address

208 Clark St
Clinton, MI 49236-9561
Phone (517) 673-4476

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1780654277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CLARK ST",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "492369561",
            "telephone_number": "517-673-4476",
            "fax_number": "734-586-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CLARK ST",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "492369561",
            "telephone_number": "517-673-4476",
            "fax_number": "734-586-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUSE",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801072025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.