Active NPI
Susan P. Trefry, PSY.D.
- Psychologist
- Melbourne, FL
National Provider Identifier
1235220609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY4270
- Practice address
- 1507 Riverview Dr
Melbourne, FL 32901-4625 - Phone
- (321) 984-0708
- Fax
- (321) 984-9060
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY4270 | FL | Primary |
Addresses
Primary practice location
1507 Riverview Dr
Melbourne, FL 32901-4625
Mailing address
1507 Riverview Dr
Melbourne, FL 32901-4625
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4270 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431302400000",
"number": "1235220609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1507 RIVERVIEW DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329014625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 RIVERVIEW DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329014625",
"telephone_number": "321-984-0708",
"fax_number": "321-984-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREFRY",
"first_name": "SUSAN",
"middle_name": "P.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2015-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY4270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.