Active NPI
Susan Proulx, PSY.D.
- Clinical Psychologist
- Swarthmore, PA
National Provider Identifier
1801912936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS 004961 L
- Practice address
- 300 S Chester Rd
Suite 105
Swarthmore, PA 19081-1800 - Phone
- (610) 357-6180
- Fax
- (610) 719-8574
- NPI assigned
- Mar 21, 2007
- 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 | PS 004961 L | PA | Primary |
Addresses
Primary practice location
300 S Chester Rd
Suite 105
Swarthmore, PA 19081-1800
Mailing address
1513 Marlboro Rd
West Chester, PA 19382-7825
Phone (610) 357-6180
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 004961 L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388620800000",
"number": "1801912936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 MARLBORO RD",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193827825",
"telephone_number": "610-357-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S CHESTER RD",
"address_2": "SUITE 105",
"city": "SWARTHMORE",
"state": "PA",
"postal_code": "190811800",
"telephone_number": "610-357-6180",
"fax_number": "610-719-8574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROULX",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2014-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS 004961 L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Swarthmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.