Individual provider Active NPI

Susan Gay Robbins, L.C.S.W.-C.

  • Mental Health Counselor
  • Havre de Grace, MD
National Provider Identifier
1861722597
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
16474 Issued in MD
Practice address
626 Revolution St
Havre de Grace, MD 21078-3320
Phone
(443) 350-3353
NPI assigned
Dec 31, 2009
Last updated
Dec 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 16474 MD Primary

Addresses

Primary practice location

626 Revolution St
Havre de Grace, MD 21078-3320

Mailing address

626 Revolution St
Havre de Grace, MD 21078-3320
Phone (443) 350-3353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110408000255 MD Practitioner - Clinical Social Worker 2264616630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 Booth St
Elkton, MD 21921-5657
Phone (410) 996-5104

626 Revolution St
Havre de Grace, MD 21078-3320
Phone (410) 939-8744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16474MDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bay Counseling and Support Services, Inc CurrentSince Jan 8, 2011 Accepting new patients
Upper Bay Counseling & Support Services, Inc. Current Accepting new patients

Locations

200 Booth St
Elkton, MD 21921
Phone (410) 996-3400

626 Revolution St
Havre de Grace, MD 21078
Phone (410) 939-8744

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1861722597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783320",
            "telephone_number": "443-350-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783320",
            "telephone_number": "443-350-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBBINS",
        "first_name": "SUSAN",
        "middle_name": "GAY",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "16474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.