DR. SUSAN ELIZABETH WILLIS (NPI# 1689627945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689627945 |
| Entity Type | Individual |
| Full Name | DR. SUSAN ELIZABETH WILLIS |
| Credential | PH.D. |
| Practice Address |
1066 W 4th St Winston-salem NC 27101-2434 |
| Practice Telephone | 3367233155 |
| Practice Fax Number | 3367341188 |
| Mailing Telephone | 3367233155 |
| Mailing Fax Number | 3367341188 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1370 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 0490C | 01 |
| NC | UNITED BEHAVIORAL SERVICE | 14751863 | 01 |
| NC | VALUEOPTIONS | 281962 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669956553 | Susan Willis | Pharmacist | 712 Highway 371, Mooreville, MS 38857-7356 | 2018-09-18 |
| 1043315187 | Susan Willis | Psychiatry & Neurology | 3123 Fairview Ave E, Seattle, WA 98102-3051 | 2006-09-13 |
| 1619975448 | Susan M. Willis | Nurse Anesthetist, Certified Registered | 7205 Lake Mead Blvd, Arlington, TX 76016-4137 | 2005-07-14 |
| 1417415340 | Susan R Willis | Counselor | 3086 State Route 160, Gallipolis, OH 45631-8409 | 2019-03-11 |
| 1528422938 | Susan Willis | Counselor | 6 Roberts Rd, Asheville, NC 28803-8699 | 2016-04-12 |
| 1396080396 | Susan Donna Willis | Nurse Practitioner | 6608 Mercy Ct Ste C, Fair Oaks, CA 95628-3171 | 2012-12-01 |
| 1316268832 | Susan Diane Willis | Marriage & Family Therapist | 3951 Performance Dr, Suite #g, Sacramento, CA 95838-3264 | 2010-06-18 |
| 1467652180 | Susan E Willis | Psychologist | 1625 The Alameda, Suite 404, San Jose, CA 95126-2220 | 2007-07-20 |
| 1578685780 | Susan Amy Willis | Counselor | 599 Canal St, Lawrence, MA 01840-1244 | 2007-04-06 |
| 1346304557 | Susan E Willis | Registered Nurse | 4000 Jennings Station Rd, Saint Louis, MO 63121-3323 | 2006-12-21 |
| Street Address |
1066 W 4TH ST |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27101-2434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578945994 | Nathan Lee Tate | Counselor | 1066 W 4th St, Winston-salem, NC 27101 | 2015-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194946947 | William Weimar Sloan Jr. | Psychologist | 2905 Briarcliffe Road, Winston-salem, NC 27106 | 2007-05-01 |
| 1265547665 | Jennifer Mccain Thomas | Psychologist | Associates In Christian Counseling, 8025 North Point Boulevard, Suite 231, Winston-salem, NC 27106-3262 | 2006-08-19 |
| 1346284163 | Elinor Terry Call | Psychologist | 1340 Ashley Sq, Winston-salem, NC 27103-2949 | 2006-06-15 |
| 1285677971 | Wayne M Sotile | Psychologist | Sotile Psychological Associates, Pllc, 1396 Old Mill Circle, Winston-salem, NC 27103 | 2006-06-13 |
| 1992744726 | Thomas Edward Hendren | Psychologist | 942 W 4th St, Winston-salem, NC 27101-2582 | 2006-06-06 |
| 1427003045 | Malcolm R Rubinstein | Psychologist | 3000 Bethesda Place, Ste 701, Winston-salem, NC 27103-3329 | 2006-05-23 |
| 1073567145 | Cristin Carr Whiting | Psychologist | 632 Holly Ave, Winston-salem, NC 27101-2716 | 2006-05-21 |
| 1669425880 | Elizabeth Carroll | Psychologist | 3779 Vest Mill Road-suite B, Winston-salem, NC 27103 | 2006-05-18 |
| 1962454728 | William L. Michielutte | Psychologist | 3779 Vest Mill Rd, Suite C, Winston-salem, NC 27103-2991 | 2006-05-17 |
| 1407822372 | Katherine T. Kelly | Psychologist | 1001 Reynolda Rd, Stockton Cottage, Winston-salem, NC 27104-3245 | 2006-02-28 |
| Find all providers in WINSTON-SALEM | ||||
| City | WINSTON-SALEM |
| Zip Code | 27101 |
Please comment or provide details below to improve the information on DR. SUSAN ELIZABETH WILLIS.
| 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.