Susan J Sampl, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1848 Issued in CT

Practice address

34 Dale Rd Ste 212
Avon, CT 06001-3659

Phone

(860) 803-9167

NPI assigned

Mar 15, 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

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Group practices

Psychological Health and Development Associates LLCGroup PAC ID 6103129333, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological Health & Development Associates, LLC

  • Psychologist
  • Wethersfield, CT
  • NPI 1144519968
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285768754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 DALE RD STE 212",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013659",
            "telephone_number": "860-803-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 DALE RD STE 212",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013659",
            "telephone_number": "860-803-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPL",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Saidel, MD
• Basant Yasser Elsayed Sallam
• Salli Shon, LLC
• Richard Salmon, M.D.
• Beth A Salonia, O.D.
• Sybil Lee Sandoval, MD
• Collin B Sanford, D.M.D.
• Ramkumar Sankaran, MD
• Joanne Andre' Santiago, DC
• Joelle Marcella Santiago, DC

• Clinical Psychologist in Avon, CT
• Providers in Avon, CT by specialty
• Clinical Psychologist in Connecticut

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.