Susan K Kauffman LMHC PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SUSAN K KAUFFMAN LMHC PLLC

Practice address

146 Depot St Ste 202
Blue Ridge, GA 30513-8503

Phone

(941) 780-4192

NPI assigned

Sep 2, 2011

Last updated

Jul 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan K Kauffman, LMHCNPI 1205820198

Title

Owner

Phone

(941) 780-4192

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan K Kauffman, LMHC

  • Mental Health Counselor
  • Blue Ridge, GA
  • NPI 1205820198
  Medicare reassignment NPD Authorized official
• Solomon Gezahgn Abebe

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1003526898
  Medicare reassignment NPD
• Alvin Ronald Seifert, PHD

  • Psychologist
  • Blue Ridge, GA
  • NPI 1689712119
  Medicare reassignment NPD
• Lance Timothy Washington

  • Psychiatric/Mental Health Nurse Practitioner
  • Decatur, GA
  • NPI 1033783998
  Medicare reassignment NPD
• Benjamin Robert Crawford, D.O.

  • Psychiatry Physician
  • Leesburg, VA
  • NPI 1215166871

  GA

  Medicare reassignment NPD
• Chinara Smith, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Loganville, GA
  • NPI 1407454366
  Medicare reassignment
• Natalie Dionne Haslem, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Powder Springs, GA
  • NPI 1164900551
  NPD (past)
• Chinwe Ibiam, NP

  • Acute Care Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1598289860

  Psychiatric/Mental Health

  NPD (past)
• Andrietta Wright Barnett, DNP FNP-C PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1043648140
  NPD (past)

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657324800000",
    "number": "1346521481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1157",
            "city": "MC CAYSVILLE",
            "state": "GA",
            "postal_code": "305551157",
            "telephone_number": "941-780-4192",
            "fax_number": "706-964-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 DEPOT ST STE 202",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305138503",
            "telephone_number": "941-780-4192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Wood St",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342377903",
            "country_code": "US",
            "telephone_number": "941-780-4192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "146 Depot St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Blue Ridge",
            "state": "GA",
            "postal_code": "305138503",
            "country_code": "US",
            "telephone_number": "706-502-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUSAN K KAUFFMAN LMHC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A",
        "authorized_official_last_name": "KAUFFMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-780-4192",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2837",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003217124B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003266024A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.kareo.com",
            "affiliation": "N",
            "endpointDescription": "software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "https://app.kareo.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://app.kareo.com",
            "address_1": "146 Depot St Ste 202",
            "city": "Blue Ridge",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305138503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://app.kareo.com/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "146 Depot St Ste 202",
            "city": "Blue Ridge",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305138503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Psychologist in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.