Active NPI
Susannah Dampier Kirksey, LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1497250773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69814
- Practice address
- 2215 Post Rd Apt 2060
Austin, TX 78704-4345 - Phone
- (512) 750-1721
- NPI assigned
- Mar 28, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 69814 | TX | Primary |
Addresses
Primary practice location
2215 Post Rd Apt 2060
Austin, TX 78704-4345
Mailing address
2215 Post Rd Apt 2060
Austin, TX 78704-4345
Phone (512) 750-1721
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14228581 | Other | CAQH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69814 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1497250773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 POST RD APT 2060",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787044345",
"telephone_number": "512-750-1721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 POST RD APT 2060",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787044345",
"telephone_number": "512-750-1721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKSEY",
"first_name": "SUSANNAH",
"middle_name": "DAMPIER",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-28",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69814",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "14228581",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.