Individual provider Active NPI

Suzanne Laub, LICSW

  • Clinical Social Worker
  • Middleboro, MA
National Provider Identifier
1811102585
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020835 Issued in MA
Practice address
94 S Main St
Middleboro, MA 02346-2123
Phone
(508) 947-6100
Fax
(508) 947-6811
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1020835 MA Primary

Addresses

Primary practice location

94 S Main St
Middleboro, MA 02346-2123

Mailing address

279 Jonathans Way
Brewster, MA 02631-2837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000505 MA Practitioner - Clinical Social Worker 8729008297 Reassigns benefits to 1 organization
Practice locations: Brewster, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

279 Jonathans Way
Brewster, MA 02631-2837
Phone (508) 737-2665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1020835MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Feb 3, 2014 Accepting new patients

Locations

94 S Main St
Middleboro, MA 02346
Phone (508) 504-8988

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811102585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 JONATHANS WAY",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 S MAIN ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023462123",
            "telephone_number": "508-947-6100",
            "fax_number": "508-947-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUB",
        "first_name": "SUZANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleboro, MA

Sources for this page

Verify at the official NPI Registry.