DR. SUSAN W. BLUE (NPI# 1366522195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366522195 |
| Entity Type | Individual |
| Full Name | DR. SUSAN W. BLUE |
| Credential | PH.D. |
| Practice Address |
804 Valley Plz Johnson City NY 13790-1009 |
| Mailing Address |
1208 Wildwood Ln Vestal NY 13850-3865 |
| Practice Telephone | 6077971100 |
| Practice Fax Number | 6077979514 |
| Mailing Telephone | 6077273903 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 010357-1 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578540431 | Susan Kelly Blue | Specialist | 1001 Washington Ave, Fort Worth, TX 76104-3049 | 2005-12-30 |
| 1760551089 | Susan Diane Blue | Physical Therapist | 275 Century Cir, Suite 103, Louisville, CO 80027-9729 | 2006-11-08 |
| 1265543839 | Susan M Blue | Nurse Practitioner | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2006-08-31 |
| Street Address |
804 VALLEY PLZ |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497944318 | Oakdale Psychology Associates | Psychologist | 804 Valley Plz, Johnson City, NY 13790-1009 | 2007-10-16 |
| 1265504211 | Jerry David Duvinsky | Psychologist | 804 Valley Plz, Johnson City, NY 13790-1009 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720261316 | Jill Stinson | Psychologist | 166 Derosier Dr, Johnson City, TN 37614-5200 | 2007-12-06 |
| 1689888141 | Deborah L Sheffey | Psychologist | 128 Keith Ln, Johnson City, TN 37601-5479 | 2007-05-10 |
| 1265500615 | Dr Tedd Stephens Edd | Psychologist | 2112 N Roan St, 6th Fl, Johnson City, TN 37601 | 2006-12-02 |
| 1780660431 | Susan Ilene Taub | Psychologist | 1604 E Oakland Ave, Johnson City, TN 37601-2151 | 2005-12-15 |
| 1558987875 | Kelly Moore Schirr | Psychologist | 166 Derosier Dr, Johnson City, TN 37614-5200 | 2020-06-23 |
| 1952897357 | Kristina S Roberts | Psychologist | 109 W Watauga Ave, Johnson City, TN 37604-5621 | 2018-07-09 |
| 1043728405 | Papillon Behavioral Health, LLC | Psychologist | 2514 1/2 Wesley St Ste 2, Johnson City, TN 37601 | 2018-01-18 |
| 1942651120 | Angela Dawn Tolley | Psychologist | 508 Princeton Rd, Suite 403, Johnson City, TN 37601-2060 | 2016-06-28 |
| 1104277656 | Ipc Pac Healthcare Services of Tennessee PC | Psychologist | 119 Boone Ridge Dr, Suite 201, Johnson City, TN 37615-4998 | 2016-06-27 |
| 1285043810 | Robert Matthew Tolliver | Psychologist | 325 N. State of Franklin Road, Ground Floor, Johnson City, TN 37604-6062 | 2014-08-07 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.