Susan Beth Kam, M.A., LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LPA#3133 Issued in NC

Practice address

63 Stamp Act Drive
Bolivia, NC 28422

Phone

(910) 253-4485

NPI assigned

Jan 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 names 1

• Mrs. Susan Walton Kam Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Coastalcare

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1316006075
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235288622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 COVINGTON DR NW",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284671893",
            "telephone_number": "910-287-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 STAMP ACT DRIVE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "28422",
            "telephone_number": "910-253-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAM",
        "first_name": "SUSAN",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "M.A., LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "LPA#3133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KAM",
            "middle_name": "WALTON",
            "prefix": "MRS.",
            "credential": "M.A., LPA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andrew Scott Johnson, PTA
• Wendy Angelina Johnston, LCSW-C
• Catalina Jordan, MS CCC-SLP
• Mark Vernon Jordan, MD
• Ryan Jordanhazy, M.D.
• Thomas B. Kiggins, LCSW, BCD
• Sarah Howell Kinsley
• Misty Kay Kirkpatrick, MA,CCC-SLP
• Ann M. Koehler, SLP
• David John Koenig, MD

• Psychologist in Bolivia, NC
• Providers in Bolivia, NC by specialty
• Psychologist in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.