Individual provider Active NPI

Susan Sanford, LICSW

  • Mental Health Counselor
  • East Bridgewater, MA
National Provider Identifier
1962754663
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1026901 Issued in MA
Practice address
362 N Bedford St
East Bridgewater, MA 02333-1148
Phone
(508) 350-2350
Fax
(508) 350-2318
NPI assigned
Oct 5, 2012
Last updated
Oct 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1026901 MA Primary

Addresses

Primary practice location

362 N Bedford St
East Bridgewater, MA 02333-1148

Mailing address

175 N Franklin St
Holbrook, MA 02343-1171
Phone (781) 767-5552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20130409000411 MA Practitioner - Clinical Social Worker 8123264546 Reassigns benefits to 2 organizations
I20260407002304 VA Practitioner - Clinical Social Worker 8123264546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

12420 Warwick Blvd
BLDG 3 Suite 4a
Newport News, VA 23606-3001
Phone (757) 594-4431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1026901MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Feb 25, 2013 Accepting new patients
Compass Medical PC CurrentSince Apr 4, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 25, 2013 Accepting new patients
Compass Medical PC CurrentSince Apr 4, 2022 Accepting new patients

Locations

1 Donalds Way
Ste 106
East Bridgewater, MA 02333
Phone (508) 350-2225

1 Donalds Way
Ste 102
East Bridgewtr, MA 02333
Phone (508) 350-2100

362 N Bedford St
East Bridgewtr, MA 02333
Phone (508) 350-2350

430 Plymouth St
Ste 100
Halifax, MA 02338
Phone (781) 422-2900

8 Commerce Blvd
Middleboro, MA 02346
Phone (774) 260-9300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1962754663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N FRANKLIN ST",
            "city": "HOLBROOK",
            "state": "MA",
            "postal_code": "023431171",
            "telephone_number": "781-767-5552",
            "fax_number": "781-986-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 N BEDFORD ST",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023331148",
            "telephone_number": "508-350-2350",
            "fax_number": "508-350-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "SUSAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1026901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Bridgewater, MA

Sources for this page

Verify at the official NPI Registry.