Active NPI
Susan Elizabeth Webster, PH.D.
- Psychologist
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY6926
- Practice address
- 10631 N Kendall Dr
Suite 115
Miami, FL 33176-1568 - Phone
- (305) 274-4330
- Fax
- (305) 274-3822
- NPI assigned
- Aug 21, 2006
- Last updated
- Apr 30, 2024
- 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 | PY6926 | FL | Primary |
| Clinical Psychologist | 103TC0700X | PY6926 | FL |
Addresses
Primary practice location
10631 N Kendall Dr
Suite 115
Miami, FL 33176-1568
Mailing address
10631 N Kendall Dr
Suite 115
Miami, FL 33176-1568
Phone (305) 274-4330
Other practice location 1
725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6926 | FL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCR Health, Inc. | Current | Accepting new patients | |
| Balanced Wellbeing LLC | Psychologist | Current | Accepting new patients |
| MCR Health, Inc. | Current | Accepting new patients | |
| Professional Health Network Inc | Past | Accepting new patients |
Locations
725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242
3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200
12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Parrish, FL
- NPI 1255376000
-
dba Riverside Medical Center
- Non-Pharmacy Dispensing Site
- Bradenton, FL
- NPI 1821878745
-
- Counselor
- Miami, FL
- NPI 1336254929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1477668051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10631 N KENDALL DR",
"address_2": "SUITE 115",
"city": "MIAMI",
"state": "FL",
"postal_code": "331761568",
"telephone_number": "305-274-4330",
"fax_number": "305-274-3822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10631 N KENDALL DR",
"address_2": "SUITE 115",
"city": "MIAMI",
"state": "FL",
"postal_code": "331761568",
"telephone_number": "305-274-4330",
"fax_number": "305-274-3822"
}
],
"practiceLocations": [
{
"address_1": "725 N 12th Ave Bldg B",
"address_purpose": "LOCATION",
"city": "Arcadia",
"state": "FL",
"postal_code": "342668752",
"country_code": "US",
"telephone_number": "863-494-1242",
"fax_number": "863-491-0466",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEBSTER",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY6926",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY6926",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.