Active NPI
Susan Lieberman Walker, PHD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1780222463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00003688
- Practice address
- 1107 NE 45TH St Ste 200
Seattle, WA 98105-4631 - Phone
- (509) 594-6331
- NPI assigned
- Dec 13, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00003688 | WA | Primary |
Addresses
Primary practice location
1107 NE 45TH St Ste 200
Seattle, WA 98105-4631
Mailing address
2901 NE Blakeley St Apt 431
Seattle, WA 98105-3168
Phone (509) 594-6331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241007000220 | WA | Practitioner - Clinical Psychologist | 8325579048 | Practice locations: Indianola, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
8147 NE Midway Ave
Indianola, WA 98342-9763
Phone (509) 594-6331
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00003688 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1780222463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 NE BLAKELEY ST APT 431",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053168",
"telephone_number": "509-594-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 NE 45TH ST STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981054631",
"telephone_number": "509-594-6331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "SUSAN",
"middle_name": "LIEBERMAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-13",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00003688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.