Individual provider Active NPI

Susan Rueda, LCSW

  • Clinical Social Worker
  • Manchester, CT
National Provider Identifier
1871821991
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006945 Issued in CT
Practice address
587 E Middle Tpke
Manchester, CT 06040-3731
Phone
(860) 646-3888
Fax
(860) 645-4132
NPI assigned
Dec 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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 006945 CT Primary

Addresses

Primary practice location

587 E Middle Tpke
Manchester, CT 06040-3731

Mailing address

587 E Middle Tpke
Manchester, CT 06040-3731
Phone (860) 646-3888

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

40 Applewood LN
Avon, CT 06001-4503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006945CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. Past Accepting new patients

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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1871821991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 E MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403731",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 E MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403731",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEDA",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.