Susan L Wickett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58992 Issued in TX

Practice address

313 Robin LN
Sallisaw, OK 74955-3028

Phone

(609) 346-8746

NPI assigned

Sep 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, TX2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, NC, TX

  Medicare reassignment NPD
• Optum Behavioral Care of Texas, P.a.

  • Clinical Social Worker
  • Richardson, TX
  • NPI 1356216022
  Medicare reassignment

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1912215369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 ROBIN LN",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749553028",
            "telephone_number": "609-346-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 ROBIN LN",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749553028",
            "telephone_number": "609-346-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKETT",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006886",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "9610",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellspring Family Clinic LLC
• Pamela Jorene West, R.PH.
• Hayley Elizabeth Weston
• Christine White
• Vicki Lynn White, BA PSYCHOLOGY, BS RW
• Wildhorse Family Practice & Urgent Care
• Wildhorse Family Practice & Urgent Care Inc
• Wildhorse Family Practice & Urgent Care Inc
• Kyle Wilhite
• Williams Medical Group Practice, LLC (Xpress Wellness Urgent Care)

• Clinical Social Worker in Sallisaw, OK
• Providers in Sallisaw, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.