Individual provider Active NPI

Susan Malfara Nallin, L.C.S.W.-C

  • Clinical Social Worker
  • Cumberland, MD
National Provider Identifier
1952507196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06295 Issued in MD
Practice address
909 Seton Dr # B
Cumberland, MD 21502-1817
Phone
(301) 777-5008
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 06295 MD Primary

Addresses

Primary practice location

909 Seton Dr # B
Cumberland, MD 21502-1817

Mailing address

1011 Braddock Rd
Cumberland, MD 21502-2626
Phone (301) 707-3352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120503000250 MD Practitioner - Clinical Social Worker 9931361250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Counseling Ministries IncGroup PAC ID 2365587995, 5 clinicians

Practice addresses (Care Compare)

907 Seton Dr
Cumberland, MD 21502-1817
Phone (301) 777-0633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06295MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Counseling Ministries Inc CurrentSince Apr 4, 2012 Accepting new patients

Locations

907 Seton Dr
Cumberland, MD 21502
Phone (301) 759-1004

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952507196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BRADDOCK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022626",
            "telephone_number": "301-707-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SETON DR # B",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021817",
            "telephone_number": "301-777-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLIN",
        "first_name": "SUSAN",
        "middle_name": "MALFARA",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.