Paul Lynn Susic, MA

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

01802 Issued in MO

Practice address

2451 Executive Dr. Ste. 103
St. Charles, MO 63303

Phone

(636) 300-9922

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Susic Psychological Consulting, PC

  • Clinical Psychologist
  • Saint Charles, MO
  • NPI 1871769406
  NPD Authorized official

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790707123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 TRAILHEAD WAY",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "63368",
            "telephone_number": "636-300-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 EXECUTIVE DR. STE. 103",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "636-300-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSIC",
        "first_name": "PAUL",
        "middle_name": "LYNN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MO",
            "license": "01802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunstone Counseling LLC
• Supportive Healthcare LLC
• Susan E. Litteken, D.D.S., P.C.
• Susan E. Pearson, LLC
• Susic Psychological Consulting, PC
• Grace Ann Sutter, DMD
• Katelyn Elizabeth Sutterer
• Kent Sutterer, DO
• Danyelle Sutton
• Jessica Swan

• Health Service Psychologist in St. Charles, MO
• Providers in St. Charles, MO by specialty
• Health Service Psychologist in Missouri

• 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.
• 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.

Verify at the official NPI Registry.