Active NPI
Susan F Broner, MSW, LICSW
- Clinical Social Worker
- Cambridge, MA
National Provider Identifier
1801989199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 102308
- Practice address
- 8F Sherman St
Cambridge, MA 02138-6710 - Phone
- (617) 497-9267
- NPI assigned
- Oct 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 102308 | MA | Primary |
Addresses
Primary practice location
8F Sherman St
Cambridge, MA 02138-6710
Mailing address
8F Sherman St
Cambridge, MA 02138-6710
Phone (617) 497-9267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1858271 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 29, 2024 through Jun 29, 2028
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": "1159660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1801989199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8F SHERMAN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021386710",
"telephone_number": "617-497-9267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8F SHERMAN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021386710",
"telephone_number": "617-497-9267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONER",
"first_name": "SUSAN",
"middle_name": "F",
"name_prefix": "Ms.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-01",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "102308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1858271",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.