NPIMap

Organization Active NPI

Susan C Haley M.D.,LLC

  • Psychiatry Physician
  • Maumee, OH
National Provider Identifier
1669076485
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SUSAN C HALEY M.D.,LLC
Practice address
1446 S Reynolds Rd Ste 215
Maumee, OH 43537-1634
Phone
(419) 794-0553
Fax
(419) 794-0554
NPI assigned
Nov 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Dr. Susan Carol Haley, MDNPI 1629005186
Title
Owner
Phone
(419) 794-0553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1446 S Reynolds Rd Ste 215
Maumee, OH 43537-1634

Mailing address

1446 S Reynolds Rd Ste 215
Maumee, OH 43537-1634
Phone (419) 794-0553

Other identifiers 1

IdentifierTypeStateIssuer
35052058OtherOHOHIO LICENSE

National Provider Directory

National Provider Directory

Locations

1446 Reynolds Rd
Ste 215
Maumee, OH 43537
Phone (419) 343-2388

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1669076485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 S REYNOLDS RD STE 215",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-794-0553",
            "fax_number": "419-794-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 S REYNOLDS RD STE 215",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371634",
            "telephone_number": "419-794-0553",
            "fax_number": "419-794-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN C HALEY M.D.,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-794-0553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "35052058",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.