Active NPI
Susan Van Giesen Evans, PSY.D.
- Clinical Psychologist
- Alpharetta, GA
National Provider Identifier
1891908380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2068
- Practice address
- 3625 Brookside Pkwy
Suite 545
Alpharetta, GA 30022-3718 - Phone
- (678) 762-0606
- NPI assigned
- May 8, 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 | 2068 | GA | Primary |
Addresses
Primary practice location
3625 Brookside Pkwy
Suite 545
Alpharetta, GA 30022-3718
Mailing address
3625 Brookside Pkwy
Suite 545
Alpharetta, GA 30022-3718
Phone (678) 762-0606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 5, 2014 through Oct 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2068 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891908380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 BROOKSIDE PKWY",
"address_2": "SUITE 545",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300223718",
"telephone_number": "678-762-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 BROOKSIDE PKWY",
"address_2": "SUITE 545",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300223718",
"telephone_number": "678-762-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "SUSAN",
"middle_name": "VAN GIESEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "2068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpharetta, GA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.