Individual provider Active NPI

Susan D. Kane-Ronning, PH.D.

  • Counseling Psychologist
  • Bellingham, WA
National Provider Identifier
1093853707
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY00001969 Issued in WA
Practice address
1117 Ellis St
Bellingham, WA 98225-5203
Phone
(360) 714-8109
Fax
(360) 756-8936
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PY00001969 WA Primary

Addresses

Primary practice location

1117 Ellis St
Bellingham, WA 98225-5203

Mailing address

3015 Silvern LN
Bellingham, WA 98226-9412
Phone (360) 714-8109

Other identifiers 2

IdentifierTypeStateIssuer
7082290MedicaidWA
8918030OtherWALABOR AND INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20090420000593 WA Practitioner - Clinical Psychologist 5496802936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY00001969WAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093853707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 SILVERN LN",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269412",
            "telephone_number": "360-714-8109",
            "fax_number": "360-756-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 ELLIS ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255203",
            "telephone_number": "360-714-8109",
            "fax_number": "360-756-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE-RONNING",
        "first_name": "SUSAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY00001969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7082290",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "8918030",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.