Active NPI
Susan Gail Hirtz, PSY.D.
- Psychologist
- Lawrence, NY
National Provider Identifier
1194039073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 010579-1
- Practice address
- 9 Sealy CT
Lawrence, NY 11559-2411 - Phone
- (516) 569-1487
- Fax
- (516) 569-1487
- NPI assigned
- Aug 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 010579-1 | NY | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 010579-1 | NY |
Addresses
Primary practice location
9 Sealy CT
Lawrence, NY 11559-2411
Mailing address
9 Sealy CT
Lawrence, NY 11559-2411
Phone (516) 569-1487
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010579-1 | NY | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1194039073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 SEALY CT",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115592411",
"telephone_number": "516-569-1487",
"fax_number": "516-569-1487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 SEALY CT",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115592411",
"telephone_number": "516-569-1487",
"fax_number": "516-569-1487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIRTZ",
"first_name": "SUSAN",
"middle_name": "GAIL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-03",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "010579-1",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "010579-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.