Individual provider Active NPI

Sue Ellen Keown, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1851494140
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R041987-01 Issued in NY
Practice address
853 Broadway
Suite 610
New York, NY 10003-4723
Phone
(212) 254-5399
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
Yes

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 R041987-01 NY Primary

Addresses

Primary practice location

853 Broadway
Suite 610
New York, NY 10003-4723

Mailing address

853 Broadway
Suite 610
New York, NY 10003-4723
Phone (212) 254-5399

Other identifiers 1

IdentifierTypeStateIssuer
P2593790OtherNYOXFORD INSURANCE CO.

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

LicenseStateTypeSpecialty
R041987-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851494140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 BROADWAY",
            "address_2": "SUITE 610",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034723",
            "telephone_number": "212-254-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 BROADWAY",
            "address_2": "SUITE 610",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034723",
            "telephone_number": "212-254-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "SUE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041987-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INSURANCE CO.",
            "identifier": "P2593790",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

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.

Verify at the official NPI Registry.