Susan Kaminski Faja, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

10089 Issued in MA

Practice address

300 Longwood Ave
Children'S Hospital Boston
Boston, MA 02115-5724

Phone

(617) 355-6000

NPI assigned

Mar 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Marie Kaminski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1497148241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AUTUMN ST",
            "address_2": "BCH3178",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155393",
            "telephone_number": "617-919-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "CHILDREN'S HOSPITAL BOSTON",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJA",
        "first_name": "SUSAN",
        "middle_name": "KAMINSKI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "10089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KAMINSKI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen G Fairbanks, DPT/PT
• Sarah Fairbrook, CRNP
• Paul Richard Faircloth Sr., MSW
• Delores A Fairweather, R.N.
• Mark Fairweather, MD
• Alexander Faje
• Vera T. Fajtova, MD
• Reza Fakhraei, MD
• Dimitrios Fakitsas
• Omolola P Fakunle

• Clinical Child & Adolescent Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.