Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Susan Shopodock, CLINICALSOCIALWORK

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1225743230

Miss. Susan Shopodock, CLINICALSOCIALWORK is a Clinical Social Worker in Manitowoc, Wisconsin. Qualified in 2021, 5 years ago. Practices with Great Lakes Clinic and Consultants, a 2-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2023
Specialties on file
4
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Practice location Address checks out

816 Washington St
Manitowoc, WI 54220-4537
Phone: (920) 645-3743
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 11553-123 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 19773 (WI)
Mental Health Counselor Taxonomy 101YM0800X
Social Worker Taxonomy 104100000X · Licence 11553-123

Record details

NPI number1225743230
Entity typeIndividual (Type 1)
GenderFemale
Credentials CLINICALSOCIALWORK
Sole proprietorNo
NPI enumeratedJanuary 16, 2023
Last updated in NPPESJuly 24, 2024
Certification dateJuly 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Great Lakes Clinic And Consultants — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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