Individual provider Active NPI

Susan Jane Bingel, LCSW

  • Clinical Social Worker
  • Leesburg, FL
National Provider Identifier
1790002103
Registry record updated Apr 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9776 Issued in FL
Practice address
33057 Professional Dr
Suite 102
Leesburg, FL 34788-7506
Phone
(352) 787-0081
Fax
(352) 314-9444
NPI assigned
Apr 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2010

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 SW9776 FL Primary

Addresses

Primary practice location

33057 Professional Dr
Suite 102
Leesburg, FL 34788-7506

Mailing address

33057 Professional Dr
Suite 102
Leesburg, FL 34788-7506
Phone (352) 787-0081

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

LicenseStateTypeSpecialty
SW9776FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Center of H.O.P.E., PA PastSince Mar 17, 1998 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": "1272067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272067200000",
    "number": "1790002103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33057 PROFESSIONAL DR",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347887506",
            "telephone_number": "352-787-0081",
            "fax_number": "352-314-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33057 PROFESSIONAL DR",
            "address_2": "SUITE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347887506",
            "telephone_number": "352-787-0081",
            "fax_number": "352-314-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGEL",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-24",
        "last_updated": "2010-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2010; 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.