Active NPI
Teresa Rene Sutherlin, LCP
- Group Psychotherapy Psychologist
- Garden City, KS
National Provider Identifier
1942425483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Group Psychotherapy Psychologist
- License
- LCP 069
- Practice address
- 531 Campus View St
Garden City, KS 67846-7904 - Phone
- (620) 275-0644
- Fax
- (620) 272-0239
- NPI assigned
- Apr 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Group Psychotherapy Psychologist | 103TP2701X | LCP 069 | KS | Primary |
Addresses
Primary practice location
531 Campus View St
Garden City, KS 67846-7904
Mailing address
613 N 12TH St
Garden City, KS 67846-5227
Phone (620) 275-1712
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCP 069 | KS | MD | Group Psychotherapy Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942425483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 N 12TH ST",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678465227",
"telephone_number": "620-275-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 CAMPUS VIEW ST",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678467904",
"telephone_number": "620-275-0644",
"fax_number": "620-272-0239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLIN",
"first_name": "TERESA",
"middle_name": "RENE",
"name_prefix": "Ms.",
"credential": "LCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "KS",
"license": "LCP 069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, KS
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.