Individual provider Active NPI

Susan Linda Mastroleo, M.A.

  • Marriage & Family Therapist
  • Syracuse, NY
National Provider Identifier
1134368376
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
#000377 Issued in NY
Practice address
917 Granger Road
Syracuse, NY 13219-2165
Phone
(315) 487-2610
NPI assigned
Feb 11, 2009
Last updated
Feb 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X #000377 NY Primary

Addresses

Primary practice location

917 Granger Road
Syracuse, NY 13219-2165

Mailing address

917 Granger Road
Syracuse, NY 13219-2165
Phone (315) 487-2610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
#000377NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1134368376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 GRANGER ROAD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192165",
            "telephone_number": "315-487-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 GRANGER ROAD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192165",
            "telephone_number": "315-487-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROLEO",
        "first_name": "SUSAN",
        "middle_name": "LINDA",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "#000377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.