Individual provider Active NPI

Susan Leibowitz, ED.D.

  • Psychologist
  • Everett, MA
National Provider Identifier
1598978561
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8178 Issued in MA
Practice address
173 Chelsea St
Everett, MA 02149-4632
Phone
(781) 388-6234
Fax
(617) 387-9768
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8178 MA Primary

Addresses

Primary practice location

173 Chelsea St
Everett, MA 02149-4632

Mailing address

180 Gardner St
Apt. 2 - 3
Arlington, MA 02474-3805
Phone (781) 648-5226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20040706000154 MA Practitioner - Clinical Psychologist 7810974193 Practice locations: Arlington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

94 Pleasant St
Suite 29
Arlington, MA 02476-6535
Phone (781) 325-5344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8178MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Care Associates, P.C. PastSince Sep 6, 1993 Accepting new patients
Child and Family Psychological Services, PLLC Psychologist PastSince Sep 19, 2018 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1598978561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 GARDNER ST",
            "address_2": "APT. 2 - 3",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024743805",
            "telephone_number": "781-648-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 CHELSEA ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021494632",
            "telephone_number": "781-388-6234",
            "fax_number": "617-387-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

Verify at the official NPI Registry.