Individual provider Active NPI

Susan Ecker Anderer, PSY.D.

  • Clinical Psychologist
  • Bryn Mawr, PA
National Provider Identifier
1245442565
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS006715L Issued in PA
Practice address
950 E Haverford Rd
Suite 300
Bryn Mawr, PA 19010-3850
Phone
(610) 581-7301
Fax
(610) 581-7690
NPI assigned
May 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS006715L PA Primary

Addresses

Primary practice location

950 E Haverford Rd
Suite 300
Bryn Mawr, PA 19010-3850

Mailing address

1326 Wyngate Rd
Wynnewood, PA 19096-2455
Phone (610) 581-7301

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
PS006715LPAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245442565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 WYNGATE RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962455",
            "telephone_number": "610-581-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E HAVERFORD RD",
            "address_2": "SUITE 300",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103850",
            "telephone_number": "610-581-7301",
            "fax_number": "610-581-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERER",
        "first_name": "SUSAN",
        "middle_name": "ECKER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS006715L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

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

Verify at the official NPI Registry.