Susan Louise Humphrey, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133000932 Issued in VA

Practice address

106 Calhoun St
Galax, VA 24333-3840

Phone

(276) 238-8885

Fax

(276) 238-8822

NPI assigned

Feb 9, 2018

Sex

Female

Sole proprietor

No

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)

Not enrolled

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 and National Provider Directory roles.

• Family Preservation Services LLC

  • Community/Behavioral Health Agency
  • Roanoke, VA
  • NPI 1093891335
  NPD (past)

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518134400000",
    "number": "1417456922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CALHOUN ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333840",
            "telephone_number": "276-238-8885",
            "fax_number": "276-238-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CALHOUN ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333840",
            "telephone_number": "276-238-8885",
            "fax_number": "276-238-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "SUSAN",
        "middle_name": "LOUISE",
        "credential": "LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hospice of Surry County, Inc
• Hospice of Surry County, Inc
• Sherry Austin Huff
• Susie Burris Huffman, LPN
• Hugh Chatham Memorial Hospital, Inc
• John O. Hurt Jr., M.D.
• Inner Anchor, LLC
• Stephen B Irvin, MD
• Alisha Chantay Isom
• Alexis Shey Jackson, PHYSICIAN ASSISTANT

• Behavior Analyst in Galax, VA
• Providers in Galax, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; 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.