Susan J Gault, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

770 Lake Cook Rd
Suite 250
Deerfield, IL 60015-4920

Phone

(847) 940-8996

Fax

(847) 267-0002

NPI assigned

Nov 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 19, 2016 through Sep 19, 2026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Jeffrey a. Fishbein, Psy.D, P.C

  dba Dr. Gault, Fishbein, and Associates

  • Psychologist
  • Deerfield, IL
  • NPI 1831321082
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427125855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 LAKE COOK RD",
            "address_2": "SUITE 250",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154920",
            "telephone_number": "847-940-8996",
            "fax_number": "847-267-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 LAKE COOK RD",
            "address_2": "SUITE 250",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154920",
            "telephone_number": "847-940-8996",
            "fax_number": "847-267-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT",
        "first_name": "SUSAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0001673500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mikhail Galperin, MD
• Tatyana Galperin, MD
• Walter Genaro Garcia Hernandez, PSYD
• Kristine Antoinette Gargiulo
• Henry Jay Gault, M.D.
• Megan Elizabeth Gaumond Oval
• Sophie Gelman
• Gentle Home Services, Inc.
• Lindsey Gercken, CCC-SLP
• Geriatric Sr Care Home Inc (Careficient Home Care Inc)

• Psychologist in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Psychologist in Illinois

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.