Active NPI
Suzan M. Stafford, EDD
- Psychologist
- Washington, DC
National Provider Identifier
1447308622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1803
- Practice address
- 4545 42ND St NW
Suite 212
Washington, DC 20016-4623 - Phone
- (202) 237-7035
- Fax
- (202) 686-3578
- NPI assigned
- Jan 6, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 483 | WV | |
| Psychologist | 103T00000X | 1803 | DC | Primary |
Addresses
Primary practice location
4545 42ND St NW
Suite 212
Washington, DC 20016-4623
Mailing address
4618 Reno Rd NW
Washington, DC 20008-2941
Phone (202) 362-6623
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1803 | DC | MD | Psychologist |
| 483 | WV | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447308622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4618 RENO RD NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200082941",
"telephone_number": "202-362-6623",
"fax_number": "202-686-3578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 42ND ST NW",
"address_2": "SUITE 212",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200164623",
"telephone_number": "202-237-7035",
"fax_number": "202-686-3578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAFFORD",
"first_name": "SUZAN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WV",
"license": "483",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "1803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.