Susan K Patrick, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3789 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

Jan 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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
  NPD (past)
• Larry Charles Stevens, PH.D., P.C.

  • Health Psychologist
  • Flagstaff, AZ
  • NPI 1417197666
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396895363",
    "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": "PATRICK",
        "first_name": "SUSAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janie Faith Pastorin
• Candace Berlynn Patel, FNP-BC
• Ian Mark Patience, MD
• Patrick Padrnos O.D. P.C. (Flagstaff Vision)
• Steven R Patrick, PH.D.
• Kelly Patterson, PA-S
• Penni L Patterson, LCSW
• Cody D. Patton, DO
• Paul D Whitney DDS PC (Country Club Dental Flagstaff)
• Leah Marie Coffman Paul, CRNA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.