SUSAN STROUP (LISW) – Clinical Social Worker, NPI 1053666487

SUSAN STROUP (LISW) is a healthcare provider. based in Canton, Ohio. specializing in Clinical Social Worker. They hold the professional credentials LISW. They hold a License No. I 1200226 (OH). The NPI Number for SUSAN STROUP (LISW) is 1053666487

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN STROUP (LISW)
NPI
1053666487
Phone
(330) 454-7066
Address
624 MARKET AVE N
Enumeration Date
23 July 2012
Last Update Date
23 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3306731347
Graduation Year
2009 (17 years ago)
PAC ID
2466794193
Group Practice PAC ID
2769474618
Professional Enrollment ID
I20190430001150
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for SUSAN STROUP (LISW)

  • 624 MARKET AVE N

    CANTON, OH 447021017

    Phone: (330) 454-7066

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-04-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190430001150IClinical Social WorkerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769474618View full group profile
NameSpecialtyState
--
-OH
Certified Clinical Nurse Specialist (Cns)OH
Nurse PractitionerOH
-OH
-OH
P S Y C H I A T R YOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

What unique ID ties claims to SUSAN STROUP (LISW)?
NPI 1053666487 is assigned to SUSAN STROUP (LISW) under the national enumeration system.
Is SUSAN STROUP (LISW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is SUSAN STROUP (LISW)?
The page reflects Clinical Social Worker for SUSAN STROUP (LISW). Clinical services aligned with this taxonomy classification.
What location metadata exists for SUSAN STROUP (LISW)?
The page summarizes Canton, Ohio for SUSAN STROUP (LISW); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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