Active NPI
Susanne Traub, LCSW MSW
- Clinical Social Worker
- Port Washington, NY
National Provider Identifier
1801961008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PR010801
- Practice address
- 35 Beacon Drive
Port Washington, NY 11050 - Phone
- (516) 883-3777
- Fax
- (516) 767-4574
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PR010801 | NY | Primary |
Addresses
Primary practice location
35 Beacon Drive
Port Washington, NY 11050
Mailing address
35 Beacon Drive
Port Washington, NY 11050
Phone (516) 883-3777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7404592 | Other | NY | GHI |
| 7404592 | Other | NY | EMPIRE VAL OPTS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PR010801 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801961008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 BEACON DRIVE",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "11050",
"telephone_number": "516-883-3777",
"fax_number": "516-767-4574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 BEACON DRIVE",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "11050",
"telephone_number": "516-883-3777",
"fax_number": "516-767-4574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAUB",
"first_name": "SUSANNE",
"name_prefix": "Mrs.",
"credential": "LCSW MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "PR010801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "7404592",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE VAL OPTS",
"identifier": "7404592",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, NY
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- Sandra Telesmanic
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- True North Dialysis Center LLC
- Maria Louise Tusa, CCC-SLP
- Diana Valcich, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.