Individual provider Active NPI

Martha Steve Sutherland, PSYD

  • Psychologist
  • Fort Collins, CO
National Provider Identifier
1750425831
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2716 Issued in CO
Practice address
19 Old Town SQ Ste 238
Fort Collins, CO 80524-2471
Phone
(970) 587-8929
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2716 CO Primary

Addresses

Primary practice location

19 Old Town SQ Ste 238
Fort Collins, CO 80524-2471

Mailing address

19 Old Town SQ Ste 238
Fort Collins, CO 80524-2471
Phone (970) 587-8929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070926000727 CO Practitioner - Clinical Psychologist 2668567371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19 Old Town SQ
Suite 238
Fort Collins, CO 80524-2471
Phone (970) 980-1194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2716COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Sutherland, PSYD, PLLC CurrentSince Jun 1, 2007 Accepting new patients

Locations

19 Old Town Sq
Ste 238
Fort Collins, CO 80524
Phone (970) 231-3721

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1750425831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 OLD TOWN SQ STE 238",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242471",
            "telephone_number": "970-587-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD TOWN SQ STE 238",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242471",
            "telephone_number": "970-587-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "MARTHA",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.