Active NPI
Susanne Richter, PSYD
- Counseling Psychologist
- Highland Park, IL
National Provider Identifier
1972666709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 071006792
- Practice address
- 480 Elm PL
Suite 104
Highland Park, IL 60035-2538 - Phone
- (847) 234-4015
- Fax
- (847) 234-4015
- NPI assigned
- Dec 19, 2006
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 071006792 | IL | Primary |
Addresses
Primary practice location
480 Elm PL
Suite 104
Highland Park, IL 60035-2538
Mailing address
480 Elm PL
Suite 104
Highland Park, IL 60035-2538
Phone (847) 234-4015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04925695 | Other | IL | BLUE SHIELD PROVIDER NUMB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 N Waukegan Rd
Suite 201
Lake Bluff, IL 60044-1660
Phone (847) 234-4015
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Highland Park, IL
- NPI 1972825164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1972666709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 ELM PL",
"address_2": "SUITE 104",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352538",
"telephone_number": "847-234-4015",
"fax_number": "847-234-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 ELM PL",
"address_2": "SUITE 104",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352538",
"telephone_number": "847-234-4015",
"fax_number": "847-234-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHTER",
"first_name": "SUSANNE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IL",
"license": "071006792",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NUMB",
"identifier": "04925695",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.