Active NPI
Susan D Mayes, PHD
- Psychologist
- Hershey, PA
National Provider Identifier
1689626558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004601L
- Practice address
- 22 Northeast Dr
Hershey, PA 17033 - Phone
- (717) 531-8338
- NPI assigned
- May 17, 2006
- 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 | PS004601L | PA | Primary |
Addresses
Primary practice location
22 Northeast Dr
Hershey, PA 17033
Mailing address
PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15016180002 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS004601L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1689626558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 858",
"address_2": "MC A410",
"city": "HERSHEY",
"state": "PA",
"postal_code": "170330858",
"telephone_number": "800-243-1455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 NORTHEAST DR",
"city": "HERSHEY",
"state": "PA",
"postal_code": "17033",
"telephone_number": "717-531-8338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYES",
"first_name": "SUSAN",
"middle_name": "D",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004601L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15016180002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hershey, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.