Individual provider Active NPI

Susan Kristine Eleeson, PH.D.

  • Psychologist
  • Beresford, SD
National Provider Identifier
1568417657
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
399 Issued in SD
Practice address
47143 299TH St
Beresford, SD 57004-6702
Phone
(605) 351-5826
NPI assigned
May 24, 2006
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 399 SD Primary

Addresses

Primary practice location

47143 299TH St
Beresford, SD 57004-6702

Mailing address

47143 299TH St
Beresford, SD 57004-6702
Phone (605) 351-5826

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)
Enrolled
Credentials
Doctor of Philosophy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1568417657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47143 299TH ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570046702",
            "telephone_number": "605-351-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47143 299TH ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570046702",
            "telephone_number": "605-351-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEESON",
        "first_name": "SUSAN",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beresford, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.