Susan P Cetlin, PHD
Individual provider Active NPI Clinical Psychologist · Sharon, MA
NPI 1689693608 · NPPES record last updated Oct 15, 2015
Key facts
- NPI
- 1689693608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 4053 (MA)
- Practice address
- 450 N Main St
450 Executive Suites
Sharon, MA 02067-0354 - Phone
- (781) 724-1189
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 9, 2022 through Mar 9, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4053 | MA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4053 | MA | Yes |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 4053 | MA |
Addresses
Primary practice location
450 N Main St
450 Executive Suites
Sharon, MA 02067-0354
Mailing address
PO Box 354
Sharon, MA 02067-0354
Phone (781) 724-1189
Other providers in Sharon, MA
- Jean Capone
- Cardinal Speech and Stuttering Therapy LLC
- Caring and Helping Home Care Agency LLC
- Caring Hands Home Services, Inc.
- Caruna Solutions Inc.
- Christopher Chapman
- Saira Chaudhry
- Ellen Kantrovitz Chella
- Chiropractic Family Health
- CHM Counseling LLC
All providers in Sharon, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.