Kathy Lynn Acus-Souders, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5311 Issued in OH

Practice address

2188 Gateway Dr
Fairborn, OH 45324-6356

Phone

(937) 864-7122

Fax

(937) 864-1950

NPI assigned

Jul 21, 2005

Last updated

Oct 16, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Kathy Acus-Souders, Psy.D., LLC

  • Clinical Psychologist
  • Fairborn, OH
  • NPI 1215112214
  Authorized official Same address or phone
• Cecilia Jacobs, Psy.D., LLC

  • Community/Behavioral Health Agency
  • Fairborn, OH
  • NPI 1134392814
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1174523070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WHIPPOORWILL CT",
            "city": "ENON",
            "state": "OH",
            "postal_code": "453239792",
            "telephone_number": "937-864-1940",
            "fax_number": "937-864-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2188 GATEWAY DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246356",
            "telephone_number": "937-864-7122",
            "fax_number": "937-864-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACUS-SOUDERS",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Grace Abel
• Aaron Abner
• Sahar Abouchahine-Allan
• Accu-Bil Management LLC (Ohio Care Home Care)
• Aaron Adams
• Danielle Dawn Adams, LSW, BSW
• Ka'la Adams
• Madison Adrien Adams
• Hannah Adkins, PHARMD, RPH

• Clinical Psychologist in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.