Individual provider Active NPI

Susan P. Trefry, PSY.D.

  • Psychologist
  • Melbourne, FL
National Provider Identifier
1235220609
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY4270 Issued in FL
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

Updated by the provider on May 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PY4270FLMDPsychologist

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.

Verify at the official NPI Registry.