Susan Smith Bouldin, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW 10109 Issued in FL

Practice address

1417 N Semoran Blvd Ste 203
Orlando, FL 32807

Phone

(407) 206-1106

Fax

(407) 206-1112

NPI assigned

Dec 21, 2010

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 names 1

• Susan Ann Smith Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Greater Orlando Psychiatric Associates, P.a.Group PAC ID 6709806284, 5 clinicians

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.

• Greater Orlando Psychiatric Associates, P.a.

  • Psychiatry Physician
  • Orlando, FL
  • NPI 1669405387
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1942503529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N SEMORAN BLVD STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073555",
            "telephone_number": "407-206-1106",
            "fax_number": "407-206-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N SEMORAN BLVD STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32807",
            "telephone_number": "407-206-1106",
            "fax_number": "407-206-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULDIN",
        "first_name": "SUSAN",
        "middle_name": "SMITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW 10109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SMITH",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ishmael Bougouneau
• Brittney Bouie
• Lamia Bouita, M.A., CCC-SLP
• Bouko Spring Health LLC
• Cassidy Peyton Boulanger
• Suzy T Boules, M.D
• Sydney Boulier, MS, RD, LDN, CNSC
• Tharwat Stewart Fouad Boulis, MD
• Lisa Jeanne Bouma Hernandez, MD
• Marsha Ann Bounds, ARNP

• Social Worker in Orlando, FL
• Providers in Orlando, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.