Active NPI
Susan Shin
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1831349455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW96757
- Practice address
- 6060 N Paramount Blvd
Long Beach, CA 90805-3711 - Phone
- (562) 634-9534
- NPI assigned
- Sep 19, 2008
- Last updated
- Jun 15, 2023
- 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 | LCSW96757 | CA | Primary |
Addresses
Primary practice location
6060 N Paramount Blvd
Long Beach, CA 90805-3711
Mailing address
6060 N Paramount Blvd
Long Beach, CA 90805-3711
Phone (562) 634-9534
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW96757 | CA | MD | Clinical Social Worker |
| 96757 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1831349455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6060 N PARAMOUNT BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908053711",
"telephone_number": "562-634-9534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6060 N PARAMOUNT BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908053711",
"telephone_number": "562-634-9534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "SUSAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-19",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW96757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.