Susan Connor Tatum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904003075 Issued in VA

Practice address

720 N Saint Asaph St
Alexandria, VA 22314-1912

Phone

(703) 838-4455

Fax

(703) 838-5070

NPI assigned

Dec 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912068800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 28TH ST S",
            "address_2": "B2",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222061375",
            "telephone_number": "703-838-4455",
            "fax_number": "703-838-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N SAINT ASAPH ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141912",
            "telephone_number": "703-838-4455",
            "fax_number": "703-838-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "SUSAN",
        "middle_name": "CONNOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "188523",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0057",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP VIRGINIA INC",
            "identifier": "298443",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "546001103002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tas-Home Health Care Agency
• Amy Samir Tashman
• Anchinlema Tassew-Asmamamw, PT
• Vanessa K Tatah
• Hammad Tatari
• Karen Taubenslag
• Kambiz Tavakkoli, D.M.D
• Kamran Tavakkoli, D.M.D
• Angela Tavolacci, BSNS
• Bibiwanhida Tawakalyar

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.