Active NPI
Janeen A Suess, LCSW
- Clinical Social Worker
- Lodi, CA
National Provider Identifier
1881965135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS22279
- Practice address
- 330 S Fairmont Ave
Suite 7
Lodi, CA 95240-3843 - Phone
- (209) 747-8558
- NPI assigned
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS22279 | CA | Primary |
Addresses
Primary practice location
330 S Fairmont Ave
Suite 7
Lodi, CA 95240-3843
Mailing address
330 S Fairmont Ave
Suite 7
Lodi, CA 95240-3843
Phone (209) 747-8558
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11792317 | Other | CA | CAQH |
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
- Opted out of Medicare
- Yes, effective Apr 16, 2018 through Apr 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22279 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| LCS22279 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1881965135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 S FAIRMONT AVE",
"address_2": "SUITE 7",
"city": "LODI",
"state": "CA",
"postal_code": "952403843",
"telephone_number": "209-747-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 S FAIRMONT AVE",
"address_2": "SUITE 7",
"city": "LODI",
"state": "CA",
"postal_code": "952403843",
"telephone_number": "209-747-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUESS",
"first_name": "JANEEN",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS22279",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11792317",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.