Susannah Devault, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005290A Issued in IN

Practice address

1480 Darlington Ave
Crawfordsville, IN 47933-2007

Phone

(765) 362-2862

Fax

(765) 362-2852

NPI assigned

Dec 5, 2011

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD (past)

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1831467836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 SPARTA ST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 DARLINGTON AVE",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479332007",
            "telephone_number": "765-362-2862",
            "fax_number": "765-362-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAULT",
        "first_name": "SUSANNAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Leann Davis, APRN
• Subodh C. Debnath, M.D.
• Reeva Del Real, DPT
• Matthew David Delang, PT, DPT
• Dental Partners of Indiana
• Kymberly Devitt, RBT
• Jessica Anne Dill
• Alison R Dobbs, MA, LMHC
• Paula Kay Dodd, P.T.
• Laura E Dolph, LMHC

• Clinical Social Worker in Crawfordsville, IN
• Providers in Crawfordsville, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.