Individual provider Active NPI

Susan R Nykamp, LICSW

  • Clinical Social Worker
  • Amherst, NH
National Provider Identifier
1881718567
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1177 Issued in NH
Practice address
109 Ponemah Rd
#8
Amherst, NH 03031-2834
Phone
(603) 491-2705
Fax
(603) 672-0344
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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 1177 NH Primary

Addresses

Primary practice location

109 Ponemah Rd
#8
Amherst, NH 03031-2834

Mailing address

109 Ponemah Rd
Ste 8
Amherst, NH 03031-2834
Phone (603) 491-2705

Other identifiers 1

IdentifierTypeStateIssuer
30422897MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040729000233 NH Practitioner - Clinical Social Worker 8325018146 Practice locations: Amherst, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 Ponemah Rd
Amherst, NH 03031-2834
Phone (603) 491-2705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1177NHMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charlene Curtis LCSW LLC Clinical 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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1881718567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PONEMAH RD",
            "address_2": "STE 8",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030312834",
            "telephone_number": "603-491-2705",
            "fax_number": "603-672-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PONEMAH RD",
            "address_2": "#8",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030312834",
            "telephone_number": "603-491-2705",
            "fax_number": "603-672-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYKAMP",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30422897",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NH

Sources for this page

Verify at the official NPI Registry.