NPIMap

Individual provider Active NPI

Susan Worten Eroraha, PH.D.

  • Clinical Psychologist
  • Laurel, MD
National Provider Identifier
1194902304
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1000113 Issued in DC
Practice address
12901 River Oak PL
Laurel, MD 20708-2349
Phone
(301) 604-1537
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY1000113 DC Primary

Addresses

Primary practice location

12901 River Oak PL
Laurel, MD 20708-2349

Mailing address

12901 River Oak PL
Laurel, MD 20708-2349
Phone (301) 604-1537

Other names 1

  • Susan Anita Worten Former name

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY1000113DCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1194902304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 RIVER OAK PL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082349",
            "telephone_number": "301-604-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 RIVER OAK PL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082349",
            "telephone_number": "301-604-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERORAHA",
        "first_name": "SUSAN",
        "middle_name": "WORTEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WORTEN",
            "middle_name": "ANITA",
            "credential": "M.A., B.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.