SUSAN HAYDAR (NPI# 1730452400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730452400 |
| Entity Type | Individual |
| Full Name | SUSAN HAYDAR |
| Credential | PHD |
| Practice Address |
5471 W Waterford Ln Appleton WI 54913-8510 |
| Mailing Address |
5337 W Grande Market Dr Appleton WI 54913-8442 |
| Practice Telephone | 9207317445 |
| Mailing Telephone | 9207317445 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2019-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3665-57 | WI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY24934 | CA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
9408 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PTAN | GF591Z | 01 |
| CA | GROUP PTAN | ZZZ20041Z | 01 |
| CA | GROUP PTAN | W14158 | 01 |
| Street Address |
5471 W WATERFORD LN |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-8510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215921127 | Karen W Beutler | Family Medicine | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2005-09-07 |
| 1235634510 | Kristin Knott | Radiology | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2018-03-28 |
| 1013362631 | Brittany Goodrich-braun | Family Medicine | 5471 W Waterford Ln, Appleton, WI 54913 | 2016-05-02 |
| 1750796488 | Kelly Thomack | Counselor | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2014-06-20 |
| 1902002371 | Kristal Kay Wichman | Social Worker | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2007-06-22 |
| 1558423517 | Joanne M Stephany | Nurse Practitioner | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2006-12-15 |
| 1558308577 | Iris N Torres | Family Medicine | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2006-05-31 |
| 1962496760 | Jose M Leiva | Family Medicine | 5471 W Waterford Ln, Appleton, WI 54913-8510 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437426368 | Nikolaus A. Werner | Psychologist | 2557 E Calumet St # A, Appleton, WI 54915-4748 | 2011-11-21 |
| 1851535009 | Deirdre Radosevich | Psychologist | 5317 W Grande Market Dr Ste F7, Appleton, WI 54913-8465 | 2009-04-30 |
| 1821048943 | Albert John Bellg | Psychologist | 1620 S Lawe St, Appleton, WI 54915-2400 | 2006-05-11 |
| 1003446089 | Mindee Juve | Psychologist | 10 Tri Park Way, Appleton, WI 54914-1658 | 2020-01-18 |
| 1770018004 | Laura Gaworski | Psychologist | 10 Tri Park Way, Appleton, WI 54914-1658 | 2017-04-24 |
| 1346622214 | Bay Center Therapy | Psychologist | 5317 W Grande Market Dr Ste F7, Appleton, WI 54913-8465 | 2015-06-26 |
| 1639550197 | Phan Yen Hong-lishner | Psychologist | W6144 Aerotech Dr, Appleton, WI 54914-7503 | 2015-06-10 |
| 1588067201 | Suzanne Arroyo | Psychologist | 5733 W Grande Market Dr, Appleton, WI 54913-8472 | 2014-10-08 |
| 1508107491 | Steven Klein, Ph.d., S.c. | Psychologist | 5733 W Grande Market Dr, Appleton, WI 54913-8472 | 2013-03-03 |
| 1679720650 | Gerald Ike Metalsky | Psychologist | 103 W College Ave, Suite 1125, Appleton, WI 54911-5770 | 2008-08-21 |
| Find all providers in APPLETON | ||||
Please comment or provide details below to improve the information on SUSAN HAYDAR.
| 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.