Active NPI
Susan Chmiel Clancy, PH.D.
- Psychologist
- Plymouth, MA
National Provider Identifier
1346587219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6729
- Practice address
- 232 Court St
Plymouth, MA 02360-4037 - Phone
- (508) 747-2718
- Fax
- (508) 747-5209
- NPI assigned
- Jan 11, 2013
- 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 | 6729 | MA | Primary |
Addresses
Primary practice location
232 Court St
Plymouth, MA 02360-4037
Mailing address
232 Court St
Plymouth, MA 02360-4037
Phone (508) 747-2718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130712000395 | MA | Practitioner - Clinical Psychologist | 6204076342 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- State University of New York at Buffalo School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
323 Court St
Plymouth, MA 02360-4322
Phone (508) 747-2718
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6729 | MA | MD | Mental Health Counselor |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357862400000",
"number": "1346587219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 COURT ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023604037",
"telephone_number": "508-747-2718",
"fax_number": "508-747-5209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 COURT ST",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023604037",
"telephone_number": "508-747-2718",
"fax_number": "508-747-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "SUSAN",
"middle_name": "CHMIEL",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-11",
"last_updated": "2013-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.