Susannah Bock Castle, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1825 Issued in OR

Practice address

5200 SW Macadam Ave
Suite 580
Portland, OR 97239-6103

Phone

(503) 970-2942

NPI assigned

Jul 20, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Susannah Castle PSYD LLC

  • Psychologist
  • Portland, OR
  • NPI 1699641183
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1194925859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "SUITE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-970-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "SUITE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-970-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLE",
        "first_name": "SUSANNAH",
        "middle_name": "BOCK",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245831",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Castillo
• Kristen Dominique Castillon, DC
• Mauri Danielle Castle Myers, MS, LMFT INTERN
• Jessica Rose Castle, M.D.
• Randy Allen Castle, DMD
• BJ Castleman, MSW, QMHP
• Megan Alexandra Castleman, M.S., CCC-SLP
• Courtney Castler
• Nicole Castonguay, MD
• Maria Isabel Castro-Mendoza

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.