Susan Daughtry Ferrell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

GA001780 Issued in GA

Practice address

66 N Rountree St
Metter, GA 30439-4019

Phone

(912) 685-6259

Fax

(912) 685-9871

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

Yes

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.

• Candler Psychological Services

  • Clinical Psychologist
  • Metter, GA
  • NPI 1710039839

  Clinical

  NPD (past) Authorized official
• M.J. Martelli, M.D.

  • Psychiatry Physician
  • Brunswick, GA
  • NPI 1265613277
  NPD (past)
• Marc W. Eaton, PH.D., P.C.

  • Clinical Psychologist
  • Waycross, GA
  • NPI 1336326289

  Clinical

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750508370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "address_2": "66 NORTH ROUNTREE STREET",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304391146",
            "telephone_number": "912-685-6259",
            "fax_number": "912-685-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 N ROUNTREE ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394019",
            "telephone_number": "912-685-6259",
            "fax_number": "912-685-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "SUSAN",
        "middle_name": "DAUGHTRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "GA001780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00529119B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvonne C. Donaldson, FNP
• Dva Healthcare Renal Care Inc
• East Georgia Healthcare Center, Inc.
• East Georgia Preventative Health Specialists, LLC
• Tracy Edwards, LPC
• Lauren Foster
• Four Seasons Senior Living, LLC
• Sarah Annlee Freeman
• Kimberly Tillman Fulmer
• Michael Edward Gasiecki, D.C.

• All providers in Metter, GA
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.