Individual provider Active NPI

Susan G Pollard, PH.D.

  • Clinical Psychologist
  • Kingwood, TX
National Provider Identifier
1477572782
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
32229 Issued in TX
Practice address
1420 Stonehollow Dr Ste C
Kingwood, TX 77339-2494
Phone
(281) 570-8227
Fax
(832) 408-7662
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 32229 TX Primary

Addresses

Primary practice location

1420 Stonehollow Dr Ste C
Kingwood, TX 77339-2494

Mailing address

1420 Stonehollow Dr Ste C
Kingwood, TX 77339-2494
Phone (281) 570-8227

Other identifiers 1

IdentifierTypeStateIssuer
86127AOtherTXBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000630 TX Practitioner - Clinical Psychologist 6305800863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1420 Stonehollow Dr
Suite C
Kingwood, TX 77339-2494
Phone (281) 570-8227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
S G Pollard PHD PLLC CurrentSince Aug 1, 2016 Accepting new patients
Athi P Venkatesh MD PA CurrentSince Jan 1, 2012 Accepting new patients

Locations

19701 Kingwood Dr
Bldg 3
Kingwood, TX 77339
Phone (281) 358-5701

1420 Stonehollow Dr
Ste C
Kingwood, TX 77339
Phone (281) 570-8227

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1477572782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 STONEHOLLOW DR STE C",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392494",
            "telephone_number": "281-570-8227",
            "fax_number": "832-408-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 STONEHOLLOW DR STE C",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392494",
            "telephone_number": "281-570-8227",
            "fax_number": "832-408-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "SUSAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "86127A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.