Individual provider Active NPI

Susan Ann Emerson, LCSW, CATC IV

  • Clinical Social Worker
  • Fullerton, CA
National Provider Identifier
1891984324
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
76479 Issued in CA
Practice address
801 E Chapman Ave
Ste. 230
Fullerton, CA 92831-3839
Phone
(714) 680-9000
NPI assigned
Oct 22, 2007
Last updated
Aug 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 76479 CA Primary

Addresses

Primary practice location

801 E Chapman Ave
Ste. 230
Fullerton, CA 92831-3839

Mailing address

801 E. Chapman Ave
Suite 230
Fullerton, CA 92831-3839
Phone (714) 680-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241023001816 CA Practitioner - Clinical Social Worker 8628501186 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76479CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hernandez Counseling & Associates Clinical CurrentSince Aug 16, 2024 Accepting new patients
Synergy Counseling Associates PastSince Aug 16, 2024 Accepting new patients

Locations

12440 Firestone Blvd
Ste 201
Norwalk, CA 90650
Phone (562) 450-0620

12440 Firestone Blvd
Ste 3001
Norwalk, CA 90650
Phone (562) 450-0620

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1891984324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E. CHAPMAN AVE",
            "address_2": "SUITE 230",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313839",
            "telephone_number": "714-680-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE",
            "address_2": "STE. 230",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313839",
            "telephone_number": "714-680-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CATC IV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.