Active NPI
Susan L. Pauly, PH.D. HSPP
- Counseling Psychologist
- Bloomington, IN
National Provider Identifier
1851474043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 20041215A
- Practice address
- 1132A S Rogers St
Bloomington, IN 47403-4770 - Phone
- (812) 335-0605
- Fax
- (812) 335-0606
- NPI assigned
- Oct 23, 2006
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 20041215A | IN | Primary |
Addresses
Primary practice location
1132A S Rogers St
Bloomington, IN 47403-4770
Mailing address
1132A S Rogers St
Bloomington, IN 47403-4770
Phone (812) 335-0605
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2027007 | Other | IN | CIGNA PIN # |
| 548896P | Other | IN | SIHO PIN # |
| NON-PAR | Other | IN | ANTHEM PIN# |
| 0007851384 | Other | IN | AETNA PIN# |
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 |
|---|---|---|---|
| 20041215A | IN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851474043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1132A S ROGERS ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474034770",
"telephone_number": "812-335-0605",
"fax_number": "812-335-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132A S ROGERS ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474034770",
"telephone_number": "812-335-0605",
"fax_number": "812-335-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULY",
"first_name": "SUSAN",
"middle_name": "L.",
"credential": "PH.D. HSPP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IN",
"license": "20041215A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN #",
"identifier": "2027007",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIHO PIN #",
"identifier": "548896P",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN#",
"identifier": "NON-PAR",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN#",
"identifier": "0007851384",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
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.