Individual provider Active NPI

Susan McCrea, PSYD

  • Counselor
  • Paoli, PA
National Provider Identifier
1770010654
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
63 Chestnut Rd Ste 9
Paoli, PA 19301-1535
Phone
(610) 557-3175
Fax
(610) 644-9010
NPI assigned
May 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

63 Chestnut Rd Ste 9
Paoli, PA 19301-1535

Mailing address

63 Chestnut Rd Ste 9
Paoli, PA 19301-1535
Phone (610) 557-3175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191028000246 PA Practitioner - Clinical Psychologist 2668704503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

900 Walnut St 2ND Floor
Jeff Hosp for Neuro
Philadelphia, PA 19107-5191
Phone (215) 955-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spotlyte Behavioral Health of Pennsylvania PC CurrentSince Jul 12, 2020 Accepting new patients
Jefferson University Physicians CurrentSince Nov 2, 2022 Accepting new patients

Locations

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

900 Walnut St
#200
Philadelphia, PA 19107
Phone (215) 955-2243

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21712/brand/4/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770010654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 CHESTNUT RD STE 9",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011535",
            "telephone_number": "610-557-3175",
            "fax_number": "610-644-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 CHESTNUT RD STE 9",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011535",
            "telephone_number": "610-557-3175",
            "fax_number": "610-644-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREA",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.