Active NPI
Susan G Raphael, LMFT
- Marriage & Family Therapist
- Westport, CT
National Provider Identifier
1518102664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001296
- Practice address
- 420 Post Rd W
Westport, CT 06880-4744 - Phone
- (203) 227-7644
- Fax
- (203) 227-0037
- NPI assigned
- Dec 3, 2008
- Last updated
- Dec 3, 2008
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001296 | CT | Primary |
Addresses
Primary practice location
420 Post Rd W
Westport, CT 06880-4744
Mailing address
420 Post Rd W
Westport, CT 06880-4744
Phone (203) 227-7644
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 |
|---|---|---|---|
| 001296 | CT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1518102664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 POST RD W",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068804744",
"telephone_number": "203-227-7644",
"fax_number": "203-227-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 POST RD W",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068804744",
"telephone_number": "203-227-7644",
"fax_number": "203-227-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPHAEL",
"first_name": "SUSAN",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-03",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.