NPIMap

Individual provider Active NPI

Susan B Stason, LICSW

  • Social Worker
  • Tewksbury, MA
National Provider Identifier
1992895767
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
105310 Issued in MA
Practice address
1565 Main St
BLDG 2 Suite 200
Tewksbury, MA 01876
Phone
(978) 851-5515
Fax
(978) 851-5561
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105310 MA Primary

Addresses

Primary practice location

1565 Main St
BLDG 2 Suite 200
Tewksbury, MA 01876

Mailing address

1565 Main St
BLDG 2 Suite 200
Tewksbury, MA 01876
Phone (978) 851-5515

Other identifiers 1

IdentifierTypeStateIssuer
105310OtherMASOC WRK LICENSE

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
105310MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia B. Criste PHD, LLC Past Accepting new patients
Joseph Deangelis Licsw LLC 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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992895767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 MAIN ST",
            "address_2": "BLDG 2 SUITE 200",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-851-5515",
            "fax_number": "978-851-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 MAIN ST",
            "address_2": "BLDG 2 SUITE 200",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-851-5515",
            "fax_number": "978-851-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASON",
        "first_name": "SUSAN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "105310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOC WRK LICENSE",
            "identifier": "105310",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.