Susan Shopodock, CLINICAL SOCIAL WORK
NPI 1225743230ActiveIndividual· Social Worker, Clinical· Manitowoc, WI
Social Worker, Clinical (CLINICAL SOCIAL WORK) with Great Lakes Clinic and Consultants, practicing in Manitowoc, Wisconsin. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1225743230 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CLINICAL SOCIAL WORK |
| Sole proprietor | No |
| NPI issued | Jan 16, 2023 |
| Last updated in NPPES | Jul 24, 2024 |
| Certified by provider | Jul 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 11553-123 | WI |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 19773 | WI |
| Counselor, Mental Health | 101YM0800X | — | — |
| Social Worker | 104100000X | 11553-123 | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WI) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Great Lakes Clinic and ConsultantsSheboygan, WI · 2 clinicians
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