Sumner Jay Sydeman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3538 Issued in AZ

Practice address

617 N Humphreys St Ste 101
Flagstaff, AZ 86001-3063

Phone

(928) 779-3783

Fax

(928) 773-1150

NPI assigned

May 4, 2007

Last updated

Apr 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anxiety Disorders and Medical Psychology Treatment Center, P.C.

  • Clinical Psychologist
  • Flagstaff, AZ
  • NPI 1518141985
  Authorized official Same address or phone
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  NPD (past)
• Larry Charles Stevens, PH.D., P.C.

  • Health Psychologist
  • Flagstaff, AZ
  • NPI 1417197666

  Clinical

  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1376755843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST STE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST STE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYDEMAN",
        "first_name": "SUMNER",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Sweets, OTR/L
• Samantha Swensen Swensen, MS
• Cassandra L Swenson, LPC
• Switzer Medical Inc (Jane Barnwell, MD)
• Michele Marie Switzer, M.D.
• Nicole Renee Sydow, M.D.
• Synaptic Psychiatry LLC (Revitalize and Optimize Clinic)
• Jessica Rose Szczepanski, PHD, RDN
• Henry Joseph Tagle III, D.M.D.
• Renee Takehara

• Clinical Psychologist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.