Individual provider Active NPI

Susan Walker Ruskin, M.S.W

  • Clinical Social Worker
  • Mill Valley, CA
National Provider Identifier
1992021380
Registry record updated Apr 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS10871 Issued in CA
Practice address
45 Camino Alto
Mill Valley, CA 94941-2929
Phone
(415) 381-8336
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS10871 CA Primary
Marriage & Family Therapist 106H00000X MFC4564 CA

Addresses

Primary practice location

45 Camino Alto
Mill Valley, CA 94941-2929

Mailing address

5106 Shelter Bay Ave
Mill Valley, CA 94941-6019
Phone (415) 381-8336

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCS10871CAMDClinical Social Worker
MFC4564CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270944000000",
    "number": "1992021380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 SHELTER BAY AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949416019",
            "telephone_number": "415-381-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CAMINO ALTO",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412929",
            "telephone_number": "415-381-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSKIN",
        "first_name": "SUSAN",
        "middle_name": "WALKER",
        "credential": "M.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2010-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS10871",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC4564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2010; 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.