DR. SUSANNAH KONDRATH (NPI# 1952927675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952927675 |
| Entity Type | Individual |
| Full Name | DR. SUSANNAH KONDRATH |
| Credential | PHD |
| Practice Address |
830 Chalkstone Ave Providence RI 02908-4734 |
| Mailing Address |
11 Eagle St Unit 222 Providence RI 02908-5642 |
| Practice Telephone | 4012737100 |
| Mailing Telephone | 7817101468 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS01867 | RI | Behavioral Health & Social Service Providers |
| Street Address |
830 CHALKSTONE AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02908-4734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174510853 | Frances Ann Bettencourt | Nurse Practitioner | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2005-09-29 |
| 1881295277 | Johnna Bussiere | Nurse's Aide | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-11-03 |
| 1770196578 | Caroline Sophie Holman | Psychologist | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-08-31 |
| 1104437458 | Vivian Vang | Registered Nurse | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-08-11 |
| 1841800604 | Wilcania Baez | Social Worker | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-08-06 |
| 1609484757 | Stephen Soonbeom Kwon | Student in an Organized Health Care Education/Training Program | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-07-15 |
| 1972111029 | Keenan Sandouk | Student in an Organized Health Care Education/Training Program | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-07-15 |
| 1952919011 | Yumna Arif | Student in an Organized Health Care Education/Training Program | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-07-15 |
| 1760009518 | Hassan Saada | Nurse Practitioner | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-06-28 |
| 1205465168 | Brandon Michael Berube | Occupational Therapist | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2020-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771900 | Horizon Wellness | Clinic/Center | 1339 Smith St, North Providence, RI 02908 | 2017-10-12 |
| 1477098069 | Beth Perry | Nurse Practitioner | 830 Chalstone Ave., Providence, RI 02908 | 2017-01-05 |
| 1659788735 | Brandi Kimble | Podiatrist | 825 Chalkstone Avenue, Providence, RI 02908 | 2014-07-21 |
| 1912253675 | Roger Williams Medical Center | Long Term Care Hospital | 25 Chalkstone Ave, Providence, RI 02908 | 2012-07-31 |
| 1669768818 | Elisa Semedo | Physical Therapist | 285 Promenade Street, Providence, RI 02908 | 2011-06-27 |
| 1255655502 | Caregiver Homes of Rhode Island Inc. | Custodial Care Facility | 235 Promenade Street, Providence, RI 02908 | 2010-03-16 |
| 1487884987 | Professional Ambulance LLC | Ambulance | 52 River Ave, Providence, RI 02908 | 2009-07-17 |
| 1609065804 | Stephen W Davis | Family Medicine | 299 Promenade Street, Nhpri, Providence, RI 02908 | 2007-10-24 |
| 1205053899 | John R Ricci | Dentist | 1252 Smith St, Providence, RI 02908 | 2007-04-18 |
| 1871718718 | Brett C Auclaire | Nurse Practitioner | 40 Candace Street, Providence, RI 02908 | 2007-04-16 |
| Find all providers in zip 02908 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225033 | Julia Michelle Kamenetsky | Psychologist | 1155 Westminster St Ste 206, Providence, RI 02909-1140 | 2020-04-29 |
| 1801430509 | Concentric Psychological Services PC | Psychologist | 205 Waterman St Ste 106, Providence, RI 02906-4313 | 2019-11-05 |
| 1073094181 | Frederick Psychological Services, LLC | Psychologist | 2 Regency Plz Ste 18, Providence, RI 02903-3143 | 2018-08-27 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1255865218 | Carly Michelle Goldstein | Psychologist | 196 Richmond St, Providence, RI 02903-4212 | 2017-04-17 |
| 1831505163 | Von Marie Rodriguez-guzman | Psychologist | Coro West Building, One Hoppin Street, Room 2.062, Providence, RI 02903 | 2014-07-08 |
| 1407262058 | Theresa Morgan | Psychologist | 593 Eddy St, Potter Bldg 2nd Floor, Dept of Psychiatry, Rhode Island Hospital, Providence, RI 02903 | 2014-07-03 |
| 1871930875 | Bernardine Pinto | Psychologist | 164 Summit Ave. Coro West, Suite 309, Miriam Hospital, Cbpm, Providence, RI 02906 | 2013-05-30 |
| 1619240009 | Shirley Yen | Psychologist | 700 Butler Dr, Providence, RI 02906-4871 | 2012-02-15 |
| 1639440449 | Sasha Lambert | Psychologist | 49 Pavilion Ave Ste 105, Providence, RI 02905-1534 | 2012-01-25 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02908 |
Please comment or provide details below to improve the information on DR. SUSANNAH KONDRATH.
| 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.