Individual provider Active NPI

Alyssa N Suess, PHD

  • Psychologist
  • Williston, ND
National Provider Identifier
1376919498
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
535 Issued in ND
Practice address
1905 14 Street West
Williston, ND 58801
Phone
(701) 651-6437
Fax
(701) 516-8462
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 535 ND
Psychologist 103T00000X 535 ND Primary

Addresses

Primary practice location

1905 14 Street West
Williston, ND 58801

Mailing address

1905 14 Street West
Williston, ND 58801
Phone (701) 651-6437

Other practice location 1

1321 W Dakota Pkwy
Williston, ND 58801-3807
Phone (701) 857-5998

Other identifiers 1

IdentifierTypeStateIssuer
1469015MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161116001283 ND Practitioner - Clinical Psychologist 8921387861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milestone Health Partners, LLCGroup PAC ID 8729483284, 10 clinicians

Practice addresses (Care Compare)

1905 14TH St W
Williston, ND 58801-4063
Phone (701) 651-6437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
535NDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Milestone Health Partners, LLC Behavior Analyst CurrentSince Feb 10, 2021 Accepting new patients
Milestone Health Partners, LLC CurrentSince Sep 11, 2022 Accepting new patients

Locations

1905 14th St W
Williston, ND 58801
Phone (701) 651-6437

205 Main St
Williston, ND 58801
Phone (701) 570-1775

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1376919498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 14 STREET WEST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "58801",
            "telephone_number": "701-651-6437",
            "fax_number": "701-516-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 14 STREET WEST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "58801",
            "telephone_number": "701-651-6437",
            "fax_number": "701-516-8462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 W Dakota Pkwy",
            "address_purpose": "LOCATION",
            "city": "Williston",
            "state": "ND",
            "postal_code": "588013807",
            "country_code": "US",
            "telephone_number": "701-857-5998",
            "fax_number": "701-857-5022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUESS",
        "first_name": "ALYSSA",
        "middle_name": "N",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ND",
            "license": "535",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469015",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.