Active NPI
Susan Edgar-Smith, PH.D.
- Clinical Psychologist
- Collegeville, PA
National Provider Identifier
1396134854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS009046L
- Practice address
- 1015 Cottonwood Dr
Collegeville, PA 19426-2884 - Phone
- (610) 405-2848
- NPI assigned
- Jan 21, 2015
- Last updated
- Jan 21, 2015
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS009046L | PA | Primary |
Addresses
Primary practice location
1015 Cottonwood Dr
Collegeville, PA 19426-2884
Mailing address
1015 Cottonwood Dr
Collegeville, PA 19426-2884
Phone (610) 405-2848
Other names 1
- Dr. Susan Edgar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1396134854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 COTTONWOOD DR",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194262884",
"telephone_number": "610-405-2848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 COTTONWOOD DR",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194262884",
"telephone_number": "610-405-2848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGAR-SMITH",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-21",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS009046L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "EDGAR",
"prefix": "DR.",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.