Individual provider Active NPI

Sue R Lerner, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Scottsdale, AZ
National Provider Identifier
1306077979
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
4019 Issued in AZ
Practice address
6773 E Gelding Dr
Scottsdale, AZ 85254-3494
Phone
(602) 320-8757
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 4019 AZ Primary
Clinical Child & Adolescent Psychologist 103TC2200X 24509 TX
School Psychologist 103TS0200X 30425 TX
School Psychologist 103TS0200X 3474589 AZ

Addresses

Primary practice location

6773 E Gelding Dr
Scottsdale, AZ 85254-3494

Mailing address

6773 E Gelding Dr
Scottsdale, AZ 85254-3494
Phone (602) 320-8757

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

LicenseStateTypeSpecialty
3474589AZMDSchool Psychologist
24509TXMDClinical Social Worker
30425TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1306077979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6773 E GELDING DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543494",
            "telephone_number": "602-320-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6773 E GELDING DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852543494",
            "telephone_number": "602-320-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERNER",
        "first_name": "SUE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "4019",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "24509",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "TX",
            "license": "30425",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "3474589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.