Active NPI
Susan M Kohaut, PHD
- Clinical Psychologist
- Portland, ME
National Provider Identifier
1255418497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS586
- Practice address
- 10 Danforth St
Portland, ME 04101 - Phone
- (207) 772-4211
- NPI assigned
- Nov 1, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 586 | ME | |
| Clinical Psychologist | 103TC0700X | PS586 | ME | Primary |
Addresses
Primary practice location
10 Danforth St
Portland, ME 04101
Mailing address
PO Box 2524
South Portland, ME 04116
Phone (207) 772-4211
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 586 | ME | MD | Clinical Psychologist |
| PS586 | ME | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1255418497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2524",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04116",
"telephone_number": "207-772-4211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 DANFORTH ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-772-4211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHAUT",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "586",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.