Individual provider Active NPI

Susan E Grober, PH.D.

  • Psychologist
  • Aventura, FL
National Provider Identifier
1710276639
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY7172 Issued in FL
Practice address
3600 Mystic PT Dr
Suite 1009
Aventura, FL 33180-2565
Phone
(786) 502-8246
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY7172 FL Primary
Psychologist 103T00000X 008928-1 NY

Addresses

Primary practice location

3600 Mystic PT Dr
Suite 1009
Aventura, FL 33180-2565

Mailing address

3600 Mystic PT Dr
Suite 1009
Aventura, FL 33180-2565
Phone (786) 502-8246

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

LicenseStateTypeSpecialty
PY7172FLMDPsychologist
008928-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1710276639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MYSTIC PT DR",
            "address_2": "SUITE 1009",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802565",
            "telephone_number": "786-502-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MYSTIC PT DR",
            "address_2": "SUITE 1009",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331802565",
            "telephone_number": "786-502-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROBER",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7172",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008928-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.