Active NPI
Susan Kelley Jones, PHD
- Clinical Psychologist
- Goose Creek, SC
National Provider Identifier
1225335169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 469
- Practice address
- 105 Central Ave Ste 200B
Goose Creek, SC 29445 - Phone
- (843) 697-1573
- NPI assigned
- Feb 11, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 469 | SC | Primary |
Addresses
Primary practice location
105 Central Ave Ste 200B
Goose Creek, SC 29445
Mailing address
1213 Saint Johns Ave
Moncks Corner, SC 29461-9203
Phone (843) 697-1573
Other practice location 1
3255 Landmark Dr
Box 101
North Charleston, SC 29418-8461
Phone (843) 697-7179
Other names 1
- Dr. Susan Park Styles
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191107003432 | SC | Practitioner - Clinical Psychologist | 8729410006 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 469 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1225335169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 SAINT JOHNS AVE",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294619203",
"telephone_number": "843-697-1573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 CENTRAL AVE STE 200B",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "29445",
"telephone_number": "843-697-1573"
}
],
"practiceLocations": [
{
"address_1": "3255 Landmark Dr",
"address_2": "Box 101",
"address_purpose": "LOCATION",
"city": "North Charleston",
"state": "SC",
"postal_code": "294188461",
"country_code": "US",
"telephone_number": "843-697-7179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JONES",
"first_name": "SUSAN",
"middle_name": "KELLEY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-11",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "STYLES",
"middle_name": "PARK",
"prefix": "DR.",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.