Susan Jocelyn, PHD
Individual provider Active NPI Clinical Psychologist · Brooklyn, NY
NPI 1811913601 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811913601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 015237 (NY)
- Practice address
- 5110 12TH Ave
Brooklyn, NY 11219-3424 - Phone
- (800) 275-3243
- Fax
- (800) 275-3671
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015237 | NY | MD | Physical Rehabilitation Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 015237 | NY | Yes |
Addresses
Primary practice location
5110 12TH Ave
Brooklyn, NY 11219-3424
Mailing address
5110 12TH Ave
Brooklyn, NY 11219-3424
Phone (800) 275-3243
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02324725 | Medicaid | NY |
Other providers in Brooklyn, NY
- Cherries Jobe
- Jobiny LLC
- Deitt Joboam
- Vicky Jocelin
- Daniel Jocelyn
- Jocelyne
- Jodan Anthony Pathinathan MD PLLC
- Radjiny Jodhan
- Nidhi Vallabhbhai Jodhani
- Jodi M Gentili
All providers in Brooklyn, NY · Clinical Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.