Individual provider Active NPI

Susan Gerette Lindblad, PH.D.

  • Psychologist
  • Hastings, NE
National Provider Identifier
1679658389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
433 Issued in NE
Practice address
5255 W Valley Rd
Hastings, NE 68901-7480
Phone
(402) 461-4163
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 433 NE Primary

Addresses

Primary practice location

5255 W Valley Rd
Hastings, NE 68901-7480

Mailing address

5255 W Valley Rd
Hastings, NE 68901-7480
Phone (402) 461-4163

Other identifiers 1

IdentifierTypeStateIssuer
10025439000MedicaidNE

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

State licenses

LicenseStateTypeSpecialty
433NEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Moscati Health Center PC Psychologist Past Accepting new patients
Alivation Health, LLC PastSince Oct 1, 2000 Accepting new patients
Family Resources of Greater Nebraska, P.C. Past Accepting new patients
Positive Solutions, Inc PastSince Mar 7, 2003 Accepting new patients

Organizations & group practices 4

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679658389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 W VALLEY RD",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689017480",
            "telephone_number": "402-461-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 W VALLEY RD",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689017480",
            "telephone_number": "402-461-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBLAD",
        "first_name": "SUSAN",
        "middle_name": "GERETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025439000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

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.

Verify at the official NPI Registry.