Active NPI
Susan Ann Hicks
- Clinical Social Worker
- Charleston, WV
National Provider Identifier
1982883211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- DP0094265D
- Practice address
- 16 Leon Sullivan Way
Suite 300
Charleston, WV 25301-2402 - Phone
- (304) 346-9689
- NPI assigned
- Nov 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | DP0094265D | WV | Primary |
Addresses
Primary practice location
16 Leon Sullivan Way
Suite 300
Charleston, WV 25301-2402
Mailing address
35 Hambrick Rd
Nitro, WV 25143-1172
Phone (304) 776-1248
Other names 1
- Susan Ann Bliss
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
| License | State | Type | Specialty |
|---|---|---|---|
| DP0094265D | WV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kanawha Pastoral Counseling Center | Clinical | Past | Accepting new patients |
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": "1193961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1982883211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 HAMBRICK RD",
"city": "NITRO",
"state": "WV",
"postal_code": "251431172",
"telephone_number": "304-776-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 LEON SULLIVAN WAY",
"address_2": "SUITE 300",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253012402",
"telephone_number": "304-346-9689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "SUSAN",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-02",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "DP0094265D",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "BLISS",
"middle_name": "ANN",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.