Active NPI
Susan L. Simonds, PH.D.
- Psychologist
- Moscow, ID
National Provider Identifier
1336249952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 363
- Practice address
- 619 S Washington St
Suite 301
Moscow, ID 83843-3090 - Phone
- (208) 892-0452
- Fax
- (208) 892-0681
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 363 | ID | Primary |
Addresses
Primary practice location
619 S Washington St
Suite 301
Moscow, ID 83843-3090
Mailing address
619 S Washington St
Suite 301
Moscow, ID 83843-3090
Phone (208) 892-0452
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 363 | ID | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336249952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 S WASHINGTON ST",
"address_2": "SUITE 301",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838433090",
"telephone_number": "208-892-0452",
"fax_number": "208-892-0681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 S WASHINGTON ST",
"address_2": "SUITE 301",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838433090",
"telephone_number": "208-892-0452",
"fax_number": "208-892-0681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONDS",
"first_name": "SUSAN",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ID",
"license": "363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.