Individual provider Active NPI

Fara Sussman Jones, MA, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1912054552
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
068361-1 Issued in NY
Practice address
406 7TH Ave
Suite 1F
Brooklyn, NY 11215-7306
Phone
(917) 359-3335
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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 068361-1 NY Primary

Addresses

Primary practice location

406 7TH Ave
Suite 1F
Brooklyn, NY 11215-7306

Mailing address

304 Windsor PL # 2
Brooklyn, NY 11218-1259
Phone (917) 359-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
068361-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1912054552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WINDSOR PL # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181259",
            "telephone_number": "917-359-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 7TH AVE",
            "address_2": "SUITE 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112157306",
            "telephone_number": "917-359-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "FARA",
        "middle_name": "SUSSMAN",
        "credential": "MA, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "068361-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.