Active NPI
Susan Rudolph, PH.D.
- Counseling Psychologist
- Corpus Christi, TX
National Provider Identifier
1770845786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 34860
- Practice address
- 13330 Leopard St
Suite 4
Corpus Christi, TX 78410-4400 - Phone
- (361) 504-4028
- Fax
- (361) 288-8409
- NPI assigned
- Jun 14, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 34860 | TX | Primary |
Addresses
Primary practice location
13330 Leopard St
Suite 4
Corpus Christi, TX 78410-4400
Mailing address
13330 Leopard St
Suite 4
Corpus Christi, TX 78410-4400
Phone (361) 504-4028
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34860 | TX | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Services Group, LLC | Counseling | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/7793/brand/1/csg/1/fhir/r4
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339632000000",
"number": "1770845786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13330 LEOPARD ST",
"address_2": "SUITE 4",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784104400",
"telephone_number": "361-504-4028",
"fax_number": "361-288-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 LEOPARD ST",
"address_2": "SUITE 4",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784104400",
"telephone_number": "361-504-4028",
"fax_number": "361-288-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-14",
"last_updated": "2012-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "34860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.