Active NPI
Susan A Sorrentino, PHD
- Psychologist
- Salem, MA
National Provider Identifier
1679605893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6294
- Practice address
- 266 Essex St
Unit #2
Salem, MA 01940 - Phone
- (978) 741-9011
- Fax
- (978) 741-8610
- NPI assigned
- Mar 12, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6294 | MA | Primary |
Addresses
Primary practice location
266 Essex St
Unit #2
Salem, MA 01940
Mailing address
266 Essex St
Unit #2
Salem, MA 01945
Phone (978) 741-9011
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 062940 | Other | MA | TUFTS |
| W05043 | Other | MA | BLUE CROSS BLUE SHIELD MA |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6294 | MA | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679605893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "266 ESSEX ST",
"address_2": "UNIT #2",
"city": "SALEM",
"state": "MA",
"postal_code": "01945",
"telephone_number": "978-741-9011",
"fax_number": "978-741-8610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 ESSEX ST",
"address_2": "UNIT #2",
"city": "SALEM",
"state": "MA",
"postal_code": "01940",
"telephone_number": "978-741-9011",
"fax_number": "978-741-8610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORRENTINO",
"first_name": "SUSAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6294",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "062940",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MA",
"identifier": "W05043",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.