Susan Lynn Wiser, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

014437 Issued in NY

Practice address

121 W Court St
Ithaca, NY 14850-4105

Phone

(607) 279-3916

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1376604512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ASSEMBLY DR UNIT 596",
            "city": "MONTREAT",
            "state": "NC",
            "postal_code": "287578031",
            "telephone_number": "607-279-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W COURT ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504105",
            "telephone_number": "607-279-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISER",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014437",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Windstein, R.N.
• Sarah Wineholt, MD
• Kari A Winkleblack Schmidt, NP
• John Joseph Winslow, DPT
• Travis F Winter, LCSW-R
• Cami Witchley
• Denise Syndee Wittlin-Horvath, LCSW-R, RN, NPP
• Isabella G Witty
• Karen Marie Wolchetsky, RN
• Tsion Haile Woldemariam, M.D.

• Psychologist in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.