Miss Susan Shopodock, CLINICAL SOCIAL WORK is a
Social Worker - Clinical based in Manitowoc, Wisconsin. Miss Susan Shopodock is licensed to practice in Wisconsin (license number 11553-123) and her current practice location is
816 Washington St, Manitowoc, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 645-3743.
NPI number for Miss Susan Shopodock is 1225743230 and her current mailing address is 816 Washington St, Manitowoc, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1225743230.
Healthcare Provider's Profile
| Full Name | Miss Susan Shopodock |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 816 Washington St, Manitowoc, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1225743230
- Provider Enumeration Date: 01/16/2023
- Last Update Date: 07/24/2024
Medical Identifiers
Medical identifiers for Miss Susan Shopodock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225743230 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19773 (Wisconsin) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | 11553-123 (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 11553-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Susan Shopodock is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Miss Susan Shopodock, CLINICAL SOCIAL WORK
816 Washington St,
Manitowoc, WI 54220-4537
Ph: (920) 652-6065 | Miss Susan Shopodock, CLINICAL SOCIAL WORK
816 Washington St,
Manitowoc, WI 54220-4537
Ph: (920) 645-3743 |
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