Susannah Colby, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120224 Issued in MA

Practice address

175 Cambridge St Ste 320
Boston, MA 02114

Phone

(617) 726-6976

NPI assigned

Dec 28, 2015

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1972968444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CAMBRIDGE ST STE 320",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142796",
            "telephone_number": "617-726-6976",
            "fax_number": "617-726-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CAMBRIDGE ST STE 320",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBY",
        "first_name": "SUSANNAH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN Y10400",
            "identifier": "Y10400",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Colavincenzo, ED.M
• Daniella Lillian Colb, PRACTICUM STUDENT
• Anne Colbert
• James A Colbert, M.D.
• Jessica L Colburn, PA-C
• Bobbi-Jo Coldwell, M.D., FRCPC
• Alexander Putnam Cole, MD
• Allan Cole
• Andrew James Cole, MD
• Clare Cole, NP

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.