Active NPI
Susan Margaret Ott, PH.D.
- Clinical Psychologist
- Shirley, MA
National Provider Identifier
1477044469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4249
- Practice address
- 2 Shaker Rd Ste D221
Shirley, MA 01464-2535 - Phone
- (978) 425-0772
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4249 | MA | Primary |
Addresses
Primary practice location
2 Shaker Rd Ste D221
Shirley, MA 01464-2535
Mailing address
110 N Main St
Petersham, MA 01366-9501
Phone (978) 724-8892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4249 | Other | MA | MA PSYCHOLOGIST |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4249 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1477044469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 N MAIN ST",
"city": "PETERSHAM",
"state": "MA",
"postal_code": "013669501",
"telephone_number": "978-724-8892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 SHAKER RD STE D221",
"city": "SHIRLEY",
"state": "MA",
"postal_code": "014642535",
"telephone_number": "978-425-0772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTT",
"first_name": "SUSAN",
"middle_name": "MARGARET",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4249",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA PSYCHOLOGIST",
"identifier": "4249",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shirley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.