Active NPI
Suzanne Lacross
- Psychologist
- Seattle, WA
National Provider Identifier
1497896310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2282
- Practice address
- 1101 Madison St
Suite 200
Seattle, WA 98014 - Phone
- (206) 545-9195
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2282 | WA | Primary |
Addresses
Primary practice location
1101 Madison St
Suite 200
Seattle, WA 98014
Mailing address
7088 94TH Ave SE
Mercer Island, WA 98040
Phone (206) 545-9195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050822000164 | WA | Practitioner - Clinical Psychologist | 2163452996 | Practice locations: Mercer Island, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3035 Island Crest Way
Mercer Island, WA 98040-2919
Phone (206) 459-4712
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2282 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497896310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7088 94TH AVE SE",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-545-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98014",
"telephone_number": "206-545-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACROSS",
"first_name": "SUZANNE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "2282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.