Mary Larson Svendsen, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

312 Issued in SC

Practice address

2138 Ashley Phosphate Road
Suite 203
North Charleston, SC 29406

Phone

(843) 569-2904

Fax

(843) 863-0837

NPI assigned

Apr 28, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary L Svendsen, PHD

  • Psychologist
  • North Charleston, SC
  • NPI 1952435083
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1083671440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 ASHLEY PHOSPHATE ROAD",
            "address_2": "SUITE 203",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-569-2904",
            "fax_number": "843-863-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 ASHLEY PHOSPHATE ROAD",
            "address_2": "SUITE 203",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-569-2904",
            "fax_number": "843-863-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVENDSEN",
        "first_name": "MARY",
        "middle_name": "LARSON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PS0065",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann E Surprenant, MD
• Advaita Susarla, DDS
• Mary Alison Sutherland, WHNP
• Shad J Sutherland, RPH
• Robert Michael Sutter, PMHNP
• Andrew Swanson, DPT
• Rhonda Kay Sweatman, R.PH.
• Kacey Butler Sweatt
• Sweet Tooth Pediatric Dentistry
• Sweetgrass Dental Associates DDS, PC

• Clinical Psychologist in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.