Suzzanne Chung, PSYD LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP 4658 Issued in MN

Practice address

10591 165TH St W
Lakeville, MN 55044-3528

Phone

(952) 898-1133

Fax

(952) 435-6797

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Life NJ PAGroup PAC ID 8921549551, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Total Life NJ P.a.

  • Cognitive & Behavioral Psychologist
  • New Brunswick, NJ
  • NPI 1104659614
  Medicare reassignment Care Compare group NPD
• True North Therapy LLC

  • Community/Behavioral Health Agency
  • Lakeville, MN
  • NPI 1649715400
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1497836480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10591 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443528",
            "telephone_number": "952-898-1133",
            "fax_number": "952-435-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10591 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443528",
            "telephone_number": "952-898-1133",
            "fax_number": "952-435-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SUZZANNE",
        "name_prefix": "Dr.",
        "credential": "PSYD LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 4658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955796200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Childlren'S Dental Care LLC
• Regina Chong, PHARMD
• Marissa Marie Christen-Tuccitto
• Pamela Christian Boldt, RN, CNS
• Colleen Lee Chung, LMFT
• Natalie Clayburn
• Leah Clayton, MT
• Rian James Cleary, O.D.
• Jenna Coghlan, DPT
• Steven D. Cohan

• Clinical Psychologist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.