Individual provider Active NPI

Susan M Linde, PH.D.

  • Counseling Psychologist
  • Tulsa, OK
National Provider Identifier
1790963288
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1055 Issued in OK
Practice address
4812 E 81St St
Ste 303
Tulsa, OK 74137-1916
Phone
(918) 747-5565
Fax
(918) 747-5568
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1055 OK Primary

Addresses

Primary practice location

4812 E 81St St
Ste 303
Tulsa, OK 74137-1916

Mailing address

4812 E 81St St
Ste 303
Tulsa, OK 74137-1916
Phone (918) 747-5565

Other identifiers 1

IdentifierTypeStateIssuer
200132320AMedicaidOK

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

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1790963288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 E 81ST ST",
            "address_2": "STE 303",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371916",
            "telephone_number": "918-747-5565",
            "fax_number": "918-747-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 E 81ST ST",
            "address_2": "STE 303",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371916",
            "telephone_number": "918-747-5565",
            "fax_number": "918-747-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OK",
            "license": "1055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200132320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.