Susan Addis PHD PA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PY 5626 Issued in FL

Legal business name

SUSAN ADDIS PHD PA

Practice address

10359 Orangewood Blvd
Orlando, FL 32821-8239

Phone

(352) 870-5302

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Susan Addis, PHD

Title

President

Phone

(352) 870-5302

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1790150977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12653 ARLEY DR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866620",
            "telephone_number": "352-870-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10359 ORANGEWOOD BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328218239",
            "telephone_number": "352-870-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN ADDIS PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "ADDIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-870-5302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "PY 5626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rose Susel
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• Laura Kathleen Susi, MD

• Professional Counselor in Orlando, FL
• Providers in Orlando, FL by specialty
• Professional Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.