Susannah Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1830 Issued in CO

Practice address

747 Pacific St.
421
Telluride, CO 81435

Phone

(970) 728-5234

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Hope Dealers of Grand Junction, LLC

  • Professional Counselor
  • Grand Junction, CO
  • NPI 1215401427
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1265599682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3258",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "814353258",
            "telephone_number": "970-728-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PACIFIC ST.",
            "address_2": "421",
            "city": "TELLURIDE",
            "state": "CO",
            "postal_code": "81435",
            "telephone_number": "970-728-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSANNAH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02680874",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rae Centanni Shaffner
• Louis J. Sharpe, M.D.
• Kristyn E. Shumway, DC
• Lisa Lynette Sink, PT
• Skyway LLC
• Robert Charles Snip, M.D.
• Allen J Solomon, MD
• Soul Embody LLP
• Southwest Colorado Mental Health Center Inc
• Southwest Colorado Mental Health Center Inc (Axis Health System)

• Clinical Psychologist in Telluride, CO
• Providers in Telluride, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.