Active NPI
Susan Frances Thibadeau, PHD BCBA
- Psychologist
- Chatham, MA
National Provider Identifier
1851436562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4406
- Practice address
- 100 Sea View Street
The May Center
Chatham, MA 02633 - Phone
- (508) 945-1147
- Fax
- (508) 945-2698
- NPI assigned
- Feb 20, 2007
- Last updated
- Jul 8, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4406 | MA | Primary |
| Psychologist | 103T00000X | PS1097 | ME | |
| Psychologist | 103T00000X | 1031075 | NU |
Addresses
Primary practice location
100 Sea View Street
The May Center
Chatham, MA 02633
Mailing address
164 Evelyns Drive
Harwich, MA 02645
Phone (508) 240-0608
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4406 | MA | MD | Psychologist |
| PS1097 | ME | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851436562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 EVELYNS DRIVE",
"city": "HARWICH",
"state": "MA",
"postal_code": "02645",
"telephone_number": "508-240-0608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SEA VIEW STREET",
"address_2": "THE MAY CENTER",
"city": "CHATHAM",
"state": "MA",
"postal_code": "02633",
"telephone_number": "508-945-1147",
"fax_number": "508-945-2698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBADEAU",
"first_name": "SUSAN",
"middle_name": "FRANCES",
"name_prefix": "Dr.",
"credential": "PHD BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "4406",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "PS1097",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": "1031075",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chatham, MA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.