SUSAN MARIE LICK (NPI# 1730714650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730714650 |
| Entity Type | Individual |
| Full Name | SUSAN MARIE LICK |
| Credential | OTR/L |
| Practice Address |
6100 Miller Ave Gary IN 46403-2469 |
| Mailing Address |
13807 W 165th Ave Lowell IN 46356-9337 |
| Practice Telephone | 2194270196 |
| Mailing Telephone | 2199516161 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 31004027A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
6100 MILLER AVE |
| City | GARY |
| State | IN |
| Zip Code | 46403-2469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609068808 | Next Level Therapeutic Services LLP | Physical Therapist | 6100 Miller Ave, Gary, IN 46403-2469 | 2007-08-13 |
| 1093346108 | Sandra Wagers | Physical Therapy Assistant | 6100 Miller Ave, Gary, IN 46403-2469 | 2020-01-28 |
| 1881234573 | Sharron Nicole Jones | Physical Therapy Assistant | 6100 Miller Ave, Gary, IN 46403-2469 | 2020-01-09 |
| 1588207625 | Ashley Gaskins | Developmental Therapist | 6100 Miller Ave, Gary, IN 46403-2469 | 2019-10-22 |
| 1295387090 | Stephanie Rene Hare-chinn | Specialist/Technologist | 6100 Miller Ave, Gary, IN 46403-2469 | 2019-07-11 |
| 1235600750 | Valerie Alicia Roth | Speech-Language Pathologist | 6100 Miller Ave, Gary, IN 46403-2469 | 2018-12-10 |
| 1174060834 | Myra J Akins | Speech-Language Pathologist | 6100 Miller Ave, Gary, IN 46403-2469 | 2017-01-19 |
| 1871972299 | Ibikunle Salami | Physical Therapist | 6100 Miller Ave, Gary, IN 46403-2469 | 2015-05-19 |
| 1841607769 | Janet Mcavoy Penner | Physical Therapy Assistant | 6100 Miller Ave, Gary, IN 46403-2469 | 2014-07-14 |
| 1710227913 | Juanita Hannon Hamlin | Speech-Language Pathologist | 6100 Miller Ave, Gary, IN 46403-2469 | 2013-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003172008 | Healthy Smiles Nwi | Dentist | 4629 Melton Rd., Gary, IN 46403 | 2012-04-04 |
| 1932494424 | Restore Therapy Services LLC | Physical Therapist | 6100 Miller Avenue, Gary, IN 46403 | 2011-06-13 |
| 1851682587 | Ladwana Retic | Social Worker | 4416 East 6th Avenue, Gary, IN 46403 | 2011-04-28 |
| 1962500298 | Lynn E Gassoway | Dentist | 8412 Maple Ave, Gary, IN 46403 | 2006-09-20 |
| 1376826867 | Jill Obrien | Pharmacist | 801 S Lake St, Gary, IN 46403 | 2011-09-21 |
| 1932314275 | Charter School of The Dunes | Local Education Agency (LEA) | 860 N Lake St, Gary, IN 46403-1070 | 2007-05-11 |
| 1598980542 | Arc Bridges, Inc | Custodial Care Facility | 7110 Forest Ave, Gary, IN 46403-1201 | 2007-04-16 |
| 1104039510 | Lynn E Gassoway,dds,inc | Clinic/Center | 8412 Maple Ave, Gary, IN 46403-1419 | 2007-05-08 |
| 1053582445 | Jacqueline Bernice Fowler | Psychologist | 8620 Maple Ave, Gary, IN 46403-1423 | 2008-03-13 |
| 1659484053 | Life Service Professional Corp | Specialist | 1015 N Shelby St, Gary, IN 46403-1446 | 2006-08-17 |
| Find all providers in zip 46403 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215100052 | Tracy Renee Haymon | Occupational Therapist | 2366 Ellsworth St, Gary, IN 46404-3300 | 2008-04-11 |
| 1255863775 | Carolyn Oros | Occupational Therapist | 700 E 21st Ave, Gary, IN 46407-2726 | 2017-04-03 |
| 1275808065 | Suma Suresh Nair | Occupational Therapist | 2350 Taft Street, Timberview Health Care, Gary, IN 46404 | 2012-03-13 |
| 1578791927 | Kathryn Demitroulas | Occupational Therapist | 6100 Miller Ave, Gary, IN 46403-2469 | 2009-06-24 |
| 1336368703 | Rosa Marie Smith | Occupational Therapist | 2350 Taft St, Gary, IN 46404-3349 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859145 | Kristina Corn | Occupational Therapist | 856 Millbrook Dr, Avon, IN 46123-7454 | 2020-10-22 |
| 1477151496 | Soshanna A Renfro | Occupational Therapist | 1789 Bethlehem Rd Ne, New Salisbury, IN 47161-7908 | 2020-10-12 |
| 1548875701 | Megan Copeland | Occupational Therapist | 8622 Central Ave, Indianapolis, IN 46240-1507 | 2020-09-14 |
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1356955652 | Bryan Weigel | Occupational Therapist | 16595 Pride Ln, Fishers, IN 46037-0081 | 2020-09-03 |
| 1699389155 | Jennifer Jo Brackney | Occupational Therapist | 5422 E County Road 600 S, Plainfield, IN 46168-8638 | 2020-09-02 |
| 1083227169 | Aegis Group Practice LLC | Occupational Therapist | 3060 Valley Farms Rd, Indianapolis, IN 46214-4501 | 2020-08-28 |
| 1619585346 | Emily Woods | Occupational Therapist | 8650 Commerce Park Pl # A-1, Indianapolis, IN 46268-3174 | 2020-07-20 |
| 1255949004 | Okot Genuine Care LLC | Occupational Therapist | 9783 E 116th St # 117, Fishers, IN 46037-2822 | 2020-07-17 |
| 1578181376 | Arminda Delph | Occupational Therapist | 1345 Unity Pl Ste 100, Lafayette, IN 47905-5760 | 2020-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.