Kamren Susanowiz, CT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2204163-TRNE Issued in OH

Practice address

5565 Airport Hwy Ste 100
Toledo, OH 43615-7391

Phone

(419) 720-5800

Fax

(419) 720-4444

NPI assigned

Oct 14, 2022

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• The Willow Center

  dba Erin Wiley LLC

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1336596550
  NPD (past)

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1265158893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 AIRPORT HWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157391",
            "telephone_number": "419-720-5800",
            "fax_number": "419-720-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 AIRPORT HWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436157391",
            "telephone_number": "419-720-5800",
            "fax_number": "419-720-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSANOWIZ",
        "first_name": "KAMREN",
        "credential": "CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204163-TRNE",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "C.2204163-TRNE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgery Center at Regency Park, LLC
• Lisa Surgo
• Pooja Suri, MD
• Pooja Suri, M.D.
• Sherlyana Surja, M.D.
• Kathleen D. K. Suter, M.A. CCC-SLP
• Edward L Sutherland, MD
• John E Sutherland
• Alice M Sutton, RN,LMT
• Alishea Ann Sutton

• Mental Health Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.