Individual provider Active NPI

Suzanne Marie Hennessey, LCSW

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1972556090
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 4560 Issued in FL
Practice address
901 S 62ND Ave
Hollywood, FL 33023-1848
Phone
(954) 893-0109
Fax
(954) 893-9750
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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 SW 4560 FL Primary

Addresses

Primary practice location

901 S 62ND Ave
Hollywood, FL 33023-1848

Mailing address

624 Still Meadows Circle
North
Palm Harbor, FL 34683-5141
Phone (727) 787-1000

Other names 1

  • Suzanne Marie Tripka Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 4560FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
American Primary Care, Inc. Past Accepting new patients
Palm Harbor Spine Center Inc Past Accepting new patients

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1972556090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 STILL MEADOWS CIRCLE",
            "address_2": "NORTH",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346835141",
            "telephone_number": "727-787-1000",
            "fax_number": "727-771-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 62ND AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330231848",
            "telephone_number": "954-893-0109",
            "fax_number": "954-893-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 4560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "TRIPKA",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.