Individual provider Active NPI

Susan Cheryl Urmetz, PSY.D.

  • Clinical Psychologist
  • Montgomery, OH
National Provider Identifier
1265556856
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P.07792 Issued in OH
Practice address
10597 Montgomery Rd Ste 201
Montgomery, OH 45242-4472
Phone
(847) 644-3687
Fax
(513) 793-5054
NPI assigned
Mar 19, 2007
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-004126 IL
Clinical Psychologist 103TC0700X P.07792 OH Primary

Addresses

Primary practice location

10597 Montgomery Rd Ste 201
Montgomery, OH 45242-4472

Mailing address

9245 Amethyst LN
West Chester, OH 45241-3863
Phone (847) 644-3687

Other practice location 1

420 Lake Cook Rd Ste 116
Deerfield, IL 60015-4914
Phone (847) 644-3687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100422000415 IL Practitioner - Clinical Psychologist 1355478496 Practice locations: Deerfield, IL
I20200505001450 OH Practitioner - Clinical Psychologist 1355478496 Practice locations: Montgomery, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10597 Montgomery Rd
Suite 201
Montgomery, OH 45242-4472
Phone (847) 644-3687

420 Lake Cook Rd
Suite 116
Deerfield, IL 60015-4914
Phone (847) 644-3687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-004126ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1265556856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 AMETHYST LN",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "452413863",
            "telephone_number": "847-644-3687",
            "fax_number": "513-793-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10597 MONTGOMERY RD STE 201",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424472",
            "telephone_number": "847-644-3687",
            "fax_number": "513-793-5054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Lake Cook Rd Ste 116",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600154914",
            "country_code": "US",
            "telephone_number": "847-644-3687",
            "fax_number": "847-405-0215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URMETZ",
        "first_name": "SUSAN",
        "middle_name": "CHERYL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004126",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.07792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.