Active NPI
Suzanne Southworth, PHD
- Psychologist
- Washington, DC
National Provider Identifier
1831147958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY100143
- Practice address
- 1327 18TH Street NW
Washington, DC 20036 - Phone
- (202) 785-2400
- Fax
- (202) 452-1853
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 03673 | MD | |
| Psychologist | 103T00000X | PSY100143 | DC | Primary |
Addresses
Primary practice location
1327 18TH Street NW
Washington, DC 20036
Mailing address
9441 Holbrook Lane
Potomac, MD 20854
Phone (301) 983-9049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041229000390 | DC | Practitioner - Clinical Psychologist | 4183682750 | Practice locations: Rockville, MD; Bethesda, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
4401 E W Hwy
Suite 405
Bethesda, MD 20814-4523
Phone (301) 509-0769
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY100143 | DC | MD | Psychologist |
| 03673 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375747200000",
"number": "1831147958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9441 HOLBROOK LANE",
"city": "POTOMAC",
"state": "MD",
"postal_code": "20854",
"telephone_number": "301-983-9049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1327 18TH STREET NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20036",
"telephone_number": "202-785-2400",
"fax_number": "202-452-1853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHWORTH",
"first_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2013-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "03673",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "DC",
"license": "PSY100143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.