Individual provider Active NPI

Susan Christine Barrett, PSY.D.

  • Psychologist
  • Nampa, ID
National Provider Identifier
1740471192
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY203136 Issued in ID
Practice address
136 N Broadmore Way Ste 103
Nampa, ID 83687-5187
Phone
(571) 554-1147
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY21349 CA
Cognitive & Behavioral Psychologist 103TB0200X PSY203136 ID
Cognitive & Behavioral Psychologist 103TB0200X PSY21349 CA
Psychologist 103T00000X PSY203136 ID Primary

Addresses

Primary practice location

136 N Broadmore Way Ste 103
Nampa, ID 83687-5187

Mailing address

322 E Main Street PMB 218
Burley, ID 83318-1933
Phone (208) 329-6647

Other practice location 1

2525 Camino Del Rio S Ste 301
San Diego, CA 92108-3784
Phone (571) 554-1147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121113000598 CA Practitioner - Clinical Psychologist 0941450050 Reassigns benefits to 1 organization
I20200911000839 ID Practitioner - Clinical Psychologist 0941450050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians
Thriveworks Clinical - California PCGroup PAC ID 1759785645, 55 clinicians

Practice addresses (Care Compare)

136 N Broadmore Way
Suite 103
Nampa, ID 83687-5187
Phone (855) 284-7483

2525 Camino del Rio S
Suite 301
San Diego, CA 92108-3784
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY21349CAMDCognitive & Behavioral Psychologist
PSY203136IDMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Sep 20, 2023 Accepting new patients
Montclair Vida Health Clinic PC PastSince Jul 21, 2017 Accepting new patients

Locations

136 N Broadmore Way
Ste 103
Nampa, ID 83687
Phone (571) 554-1147

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 3

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1740471192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E MAIN STREET PMB 218",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833181933",
            "telephone_number": "208-329-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N BROADMORE WAY STE 103",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875187",
            "telephone_number": "571-554-1147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Camino Del Rio S Ste 301",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921083784",
            "country_code": "US",
            "telephone_number": "571-554-1147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "SUSAN",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21349",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "ID",
            "license": "PSY203136",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY21349",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ID",
            "license": "PSY203136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.