Individual provider Active NPI

Susan R Berger, ED.D,

  • Psychologist
  • Brookline, MA
National Provider Identifier
1912069857
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
HSP280 Issued in MA
Practice address
155 Sewall Avenue
Brookline, MA 02446-5240
Phone
(617) 645-9672
Fax
(617) 277-8638
NPI assigned
Dec 15, 2006
Last updated
Apr 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X HSP280 MA Primary
Social Worker 104100000X SW2030272 MA

Addresses

Primary practice location

155 Sewall Avenue
Brookline, MA 02446-5240

Mailing address

155 Sewall Avenue
Brookline, MA 02446-5240
Phone (617) 645-9672

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Sep 28, 2019 through Sep 28, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
HSP280MAMDPsychologist
SW2030272MAMDSocial Worker
280MAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1912069857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 SEWALL AVENUE",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465240",
            "telephone_number": "617-645-9672",
            "fax_number": "617-277-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SEWALL AVENUE",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465240",
            "telephone_number": "617-645-9672",
            "fax_number": "617-277-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "SUSAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "ED.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "HSP280",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "SW2030272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.