Active NPI
Susan Browning Wadsworth, ED.D.
- Psychologist
- Newton, MA
National Provider Identifier
1235246885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4378
- Practice address
- 410 Woodward St.
Newton, MA 02468 - Phone
- (617) 498-9772
- NPI assigned
- Aug 23, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4378 | MA | Primary |
Addresses
Primary practice location
410 Woodward St.
Newton, MA 02468
Mailing address
410 Woodward Street
Newton, MA 02468
Phone (617) 498-9772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 13, 2020 through Jul 13, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235246885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 WOODWARD STREET",
"city": "NEWTON",
"state": "MA",
"postal_code": "02468",
"telephone_number": "617-498-9772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 WOODWARD ST.",
"city": "NEWTON",
"state": "MA",
"postal_code": "02468",
"telephone_number": "617-498-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADSWORTH",
"first_name": "SUSAN",
"middle_name": "BROWNING",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "4378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.