DR. SUSAN RUE WILSON (NPI# 1417061730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417061730 |
| Entity Type | Individual |
| Full Name | DR. SUSAN RUE WILSON |
| Credential | ED.D. |
| Practice Address |
460 Quincy Ave Quincy MA 02169-8130 |
| Practice Telephone | 6177746070 |
| Mailing Telephone | 6177746070 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
7554 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891287306 | Susan Wilson | Technician | 11302 Sperry Stream Way, Bowie, MD 20720-3431 | 2018-05-31 |
| 1093202939 | Susan Faith Wilson | Counselor | 1555 Brae Moor Ln, Dunedin, FL 34698-3212 | 2018-04-17 |
| 1306358247 | Susan Wilson | Social Worker | 1931 Horton Rd Ste 3, Jackson, MI 49203-5599 | 2017-11-01 |
| 1780101857 | Susan C Wilson | Social Worker | 8135 Mount Vernon Rd., St. Lousiville, OH 43071 | 2017-08-29 |
| 1114466372 | Susan Kay Wilson | Social Worker | 919 Superior Dr, Huron, OH 44839-1454 | 2017-02-20 |
| 1831559111 | Susan Wilson | Case Manager/Care Coordinator | 24 Riverside Dr, Independence, VA 24348-3746 | 2016-03-01 |
| 1801284302 | Susan Lynn Wilson | Registered Nurse | 2988 Moyer Ave, Norton, OH 44203 | 2015-01-06 |
| 1558766105 | Susan Wilson | Social Worker | 318 Lake Marina Ave, 212, New Orleans, LA 70124-1600 | 2014-10-24 |
| 1366716854 | Susan Elizabeth Wilson | Midwife | 5410 Hill Crest St, Russellville, MO 65074-1213 | 2012-02-29 |
| 1477888261 | Susan Wilson | Licensed Practical Nurse | 17 E Haddon Ave, Oaklyn, NJ 08107-1308 | 2009-10-12 |
| Street Address |
460 QUINCY AVE |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-8130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407884059 | The Commonwealth of Massachusetts | Psychiatric Hospital | 460 Quincy Ave, Quincy, MA 02169-8130 | 2006-06-30 |
| 1285235200 | Veneza Monteiro | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-11-05 |
| 1821605429 | Christopher Peter Wallack I | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-09-28 |
| 1689285561 | Angela Wang | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-08-13 |
| 1336767813 | Priscilla Gouldbourne | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-07-10 |
| 1083231351 | Christine Leigh Dipaolo | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-07-02 |
| 1245853860 | Sally Ann Potkay | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-05-19 |
| 1669093456 | Ashley Sullivan | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-05-03 |
| 1003448457 | Tom F Chappuis Jr. | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-02-04 |
| 1528699154 | Theresa Lepore | Counselor | 460 Quincy Ave, Quincy, MA 02169-8130 | 2020-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033292479 | Michael W Barclay | Psychologist | 417 1st St, Quincy, CA 95971 | 2006-10-21 |
| 1215556675 | Robert Holloway IIi | Psychologist | 500 Victory Rd, Quincy, MA 02171-3139 | 2020-04-15 |
| 1164553210 | Susan Elaine D'esposito | Psychologist | 859 Willard St, Quincy, MA 02169-7482 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575786 | Eavan Miles-mason, Phd, LLC | Psychologist | 319 Peakham Rd, Sudbury, MA 01776-2757 | 2020-07-14 |
| 1184247132 | Lauren R Blakely | Psychologist | 96 Fairbanks Ave, Wellesley, MA 02481-5256 | 2020-05-26 |
| 1881220986 | Katharine Dunson Oconnell | Psychologist | 144 Forest St, Wellesley Hills, MA 02481-6832 | 2020-03-20 |
| 1710457577 | Karla Lizbet Rivas | Psychologist | 44 Mansfield St, Allston, MA 02134 | 2018-12-04 |
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1043706419 | Jessica Shepley | Psychologist | 72 Fox Hill Rd, Bernardston, MA 01337-9586 | 2018-07-09 |
| 1548755176 | Elizabeth F Clark | Psychologist | 16 Gleasondale Rd, Stow, MA 01775-1465 | 2018-06-26 |
| 1528552619 | Heather Duckworth Smith | Psychologist | 5 Seal Cove Ln, Hingham, MA 02043-1050 | 2018-06-21 |
| 1467946251 | Olivia Moorehead-slaughter | Psychologist | 171 Goddard Ave, Brookline, MA 02445-7412 | 2018-06-15 |
| 1710479522 | David Arnold | Psychologist | 35 Hop Brook Rd, Amherst, MA 01002-2771 | 2018-06-06 |
| Find all providers with the same taxonomy | ||||
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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.