Susan Michelle Hagerich, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113899 Issued in MA

Practice address

130 Centre St
Fuller House, Suite 101
Danvers, MA 01923

Phone

(978) 548-6316

Fax

(978) 532-0200

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1801940473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CENTRE ST",
            "address_2": "FULLER HOUSE, SUITE 101",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "01923",
            "telephone_number": "978-548-6316",
            "fax_number": "978-532-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CENTRE ST",
            "address_2": "FULLER HOUSE, SUITE 101",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "01923",
            "telephone_number": "978-548-6316",
            "fax_number": "978-532-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERICH",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karuna L Gupta, MD
• Rosibel Guzman, NURSE PRACTITIONER
• Susan A. Haas, LICSW
• Jessica Hagen
• Lisa Hagen
• Susan Ann Haines, BA
• Kimberley Jean Haley, L.M.H.C.
• Meredith Grace Haley, D.O
• Hall Family Chiropractic
• Jonathan Hall, MA LADC

• Clinical Social Worker in Danvers, MA
• Providers in Danvers, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.