SUSIC PSYCHOLOGICAL CONSULTING, PC (NPI# 1871769406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871769406 |
| Entity Type | Organization |
| Organization Name | SUSIC PSYCHOLOGICAL CONSULTING, PC |
| Other Organization Name | SENIOR CARE PSYCHOLOGICAL CONSULTING |
| Practice Address |
2451 Executive Dr Ste 103 Saint Charles MO 63303-5606 |
| Mailing Address |
350 Trailhead Way Dardenne Prairie MO 63368-7588 |
| Practice Telephone | 6363009922 |
| Practice Fax Number | 6363009924 |
| Mailing Telephone | 6363009922 |
| Mailing Fax Number | 6363009924 |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2008-05-04 |
| Authorized Official Name | PAUL L. SUSIC (CEO/PRESIDENT) |
| Authorized Official Telephone | 6363009922 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
01802 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 498592518 | 05 |
| Other Name | Type Code |
|---|---|
| SENIOR CARE PSYCHOLOGICAL CONSULTING | Doing Business As Name - Organization |
| Street Address |
2451 EXECUTIVE DR STE 103 |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63303-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214787 | Michael Frederick | Pharmacist | 2855 Veterans Memorial Parkway, (pharmacy), Saint Charles, MO 63303 | 2020-10-30 |
| 1710525639 | Cheryl Ann O'dell | Pharmacist | Schnucks Pharmacy, 60 Harvester Square, St Charles, MO 63303 | 2019-12-11 |
| 1255821302 | Melinda R Winfield | Nurse Practitioner | 1313 Park Ct, Saint Charles, MO 63303 | 2018-05-15 |
| 1467904839 | Heather Lilledahl | Speech-Language Pathologist | 2800 Old Muegge Road, Saint Charles, MO 63303 | 2016-11-01 |
| 1437608312 | Preferred Family Healthcare | Counselor | 1559 Old S. River Road, St.charles, MO 63303 | 2016-10-03 |
| 1487109146 | Annette Patricia Davenport | Nurse Practitioner | 1551 Wall Street, Logistics Health Inc, Suite 100, Saint Charles, MO 63303 | 2016-08-23 |
| 1053762328 | Sarah Biondo | Speech-Language Pathologist | 7204 Fountainview Circle, Ofallon, MO 63303 | 2016-06-28 |
| 1710331335 | Lindsey Ann Eilers | Counselor | 1570 South Main, Saint Charles, MO 63303 | 2016-04-20 |
| 1174914600 | Jacquelyn Michele Miller | Pharmacy Technician | 3881 Mexico Road, Saint Charles, MO 63303 | 2015-02-05 |
| 1164838132 | Francelle Denise Neal | Counselor | 2480 Executive Dr Ste 111, Saint Charles, MO 63303 | 2014-07-10 |
| Find all providers in zip 63303 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447722129 | Kimberly Loucks | Psychologist | 2580 Foxfield Rd Ste 101, Saint Charles, IL 60174-1403 | 2018-12-19 |
| 1467757013 | Carrie Lewis | Psychologist | 1049 1st Capitol Dr, Saint Charles, MO 63301-1952 | 2011-01-12 |
| 1689993164 | Jennifer Lynn Evans | Psychologist | 2451 Executive Dr, Suite 103, Saint Charles, MO 63303-5606 | 2010-05-24 |
| 1932331329 | Della Madeline Halper | Psychologist | 2210 Dean St Ste I, Saint Charles, IL 60175-1067 | 2009-08-18 |
| 1467524918 | Cherry Dee Weber | Psychologist | 80 Dunham Pl, Saint Charles, IL 60174-5701 | 2006-11-13 |
| 1609314277 | James Linsin | Psychologist | 58 Portwest Ct, Saint Charles, MO 63303-5985 | 2017-02-03 |
| 1235599341 | Chalenna C. Cassell | Psychologist | 1551 Wall St, Saint Charles, MO 63303-3539 | 2016-03-02 |
| 1417215831 | Tanya Christina Gluzerman | Psychologist | 3381 W Main St, Suite 1, Saint Charles, IL 60175-1008 | 2012-04-24 |
| 1629309877 | Michelle Bidwell | Psychologist | 1120 E Main St, Suite 101, Saint Charles, IL 60174-2287 | 2010-01-27 |
| 1982880548 | Amy Joy Marty | Psychologist | 102 Compass Point Dr, Saint Charles, MO 63301 | 2008-01-14 |
| Find all providers in SAINT CHARLES | ||||
| City | SAINT CHARLES |
| Zip Code | 63303 |
Please comment or provide details below to improve the information on SUSIC PSYCHOLOGICAL CONSULTING, PC.
| 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.