Individual provider Active NPI

Karen Sue Suetterlein, PSYD.

  • Clinical Psychologist
  • Newark, DE
National Provider Identifier
1922369784
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
B1-0001201 Issued in DE
Practice address
300 Biddle Ave Ste 207
Newark, DE 19702-3972
Phone
(302) 224-1400
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05122 MD
Clinical Psychologist 103TC0700X B1-0001201 DE Primary

Addresses

Primary practice location

300 Biddle Ave Ste 207
Newark, DE 19702-3972

Mailing address

504 Beechwood CT
Bear, DE 19701-5307
Phone (302) 836-5329

Other practice location 1

1275B W Pulaski Hwy
Elkton, MD 21921-4719
Phone (410) 620-7161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121112000185 MD Practitioner - Clinical Psychologist 5193976546 Reassigns benefits to 2 organizations
I20210715000092 DE Practitioner - Clinical Psychologist 5193976546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-Atlantic Behavioral Health, LLCGroup PAC ID 3375620016, 88 clinicians

Practice addresses (Care Compare)

300 Biddle Ave
Suite 207
Newark, DE 19702-3972
Phone (302) 224-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05122MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Bay Counseling & Support Services, Inc. Current Accepting new patients
Mid-Atlantic Behavioral Health, LLC Clinical CurrentSince Jul 9, 2021 Accepting new patients
Supportive Care of Maryland LLC CurrentSince May 15, 2021 Accepting new patients

Locations

735 Mapleton Ave
Ste 200
Middletown, DE 19709
Phone (302) 563-8713

300 Biddle Ave
Ste 207
Newark, DE 19702
Phone 3022241400 ext. 614

910 S Chapel St
Ste 102
Newark, DE 19713
Phone 3022241400 ext. 614

200 Booth St
Elkton, MD 21921
Phone (410) 996-3400

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1922369784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 BEECHWOOD CT",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197015307",
            "telephone_number": "302-836-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIDDLE AVE STE 207",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023972",
            "telephone_number": "302-224-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275B W Pulaski Hwy",
            "address_purpose": "LOCATION",
            "city": "Elkton",
            "state": "MD",
            "postal_code": "219214719",
            "country_code": "US",
            "telephone_number": "410-620-7161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUETTERLEIN",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05122",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0001201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.