Individual provider Active NPI

Susan Sindel Villasana, PSYCHOLOGIST

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1245369123
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY01398 Issued in MO
Practice address
8 Ridgemoor Dr
Saint Louis, MO 63105-3038
Phone
(314) 862-2567
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY01398 MO Primary

Addresses

Primary practice location

8 Ridgemoor Dr
Saint Louis, MO 63105-3038

Mailing address

8 Ridgemoor Dr
Saint Louis, MO 63105-3038
Phone (314) 862-2567

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY01398MOMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245369123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RIDGEMOOR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053038",
            "telephone_number": "314-862-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RIDGEMOOR DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053038",
            "telephone_number": "314-862-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASANA",
        "first_name": "SUSAN",
        "middle_name": "SINDEL",
        "name_prefix": "Ms.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "PY01398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.