Susan Irene Chamberlain, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

9307447-2501 Issued in UT

Practice address

331 S 600 E
Salt Lake City, UT 84102-4013

Phone

(801) 613-7305

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Mend Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reno, NV
  • NPI 1396634994
  NPD Authorized official

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1447311055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 GRANITE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895093925",
            "telephone_number": "812-325-3666",
            "fax_number": "775-327-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S 600 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841024013",
            "telephone_number": "801-613-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 E Flamingo Rd",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891217483",
            "country_code": "US",
            "telephone_number": "702-486-7588",
            "fax_number": "702-486-7522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "SUSAN",
        "middle_name": "IRENE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY1139",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "9307447-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Todd Chamberlain, D.O.
• Michelle A Chamberlain, MD
• Rebecca Askew Chamberlain
• Riley Jo Chamberlain
• Stephanie Chamberlain, LCSW
• Will Chamberlain, MD
• Amber Chambers
• Anne Chambers
• Chelsea Chambers, MS
• Jaci Don Chambers, PA-C

• Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.