Ann Elizabeth Srodulski, MA

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

1500 NE Irving St
Suite 250
Portland, OR 97232-2243

Phone

(503) 258-4200

NPI assigned

Aug 21, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• A New Day Dawning Integrative Psychology Associates PLLC

  • Psychologist
  • Rolling Meadows, IL
  • NPI 1760342489
  NPD Authorized official
• Srodulski Psychological Services, PLLC

  • Clinical Psychologist
  • Rolling Meadows, IL
  • NPI 1649931445
  NPD Authorized official

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

{
    "created_epoch": "1313884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313884800000",
    "number": "1538449673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9479 SW MAPLEWOOD DR",
            "address_2": "B14",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234966",
            "telephone_number": "847-502-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NE IRVING ST",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322243",
            "telephone_number": "503-258-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRODULSKI",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-21",
        "last_updated": "2011-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandhya Venkata Srikantom, MD
• Renganathan Srinivasan, M.D.
• June Suparatana Srisethnil, PT
• Amar Srivastava, M.D.
• Rungrudee Sriyoung, RN
• Sssht Opco SE Division Street, LLC
• Michael Anthony St Amand, PAC
• Karen St Clair, LCSW
• Keeley Swete St Clair, MT-BC
• Pamela Jean St Clair, FNP-BC

• Clinical Child & Adolescent Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Child & Adolescent Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2011; 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.