DR. SUSAN BENNETT (NPI# 1972623510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972623510 |
| Entity Type | Individual |
| Full Name | DR. SUSAN BENNETT |
| Credential | PHD |
| Practice Address |
4915 N Interstate Ave Portland OR 97217-3624 |
| Practice Telephone | 5037053852 |
| Mailing Telephone | 5037053852 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 749 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043633605 | Susan Bennett | Physical Therapy Assistant | 2314 Forest Ave, Durango, CO 81301-4867 | 2014-01-31 |
| 1497184162 | Susan Bennett | Registered Nurse | 1265 Ravenshoe Way, Chico, CA 95973-9138 | 2013-11-04 |
| 1760816821 | Susan C Bennett | Licensed Vocational Nurse | 5109b W Enterprise St, North Charleston, SC 29405-4066 | 2013-08-26 |
| 1083991236 | Susan Leslie Bennett | Psychologist | 4700 Hale Pkwy Ste 380, Denver, CO 80220-4023 | 2011-11-15 |
| 1891076782 | Susan Raye Bennett | Counselor | 604 N Porter St, Seaford, DE 19973-2441 | 2011-09-06 |
| 1205139250 | Susan Bennett | Speech-Language Pathologist | 1030 W 33rd St, Erie, PA 16508-2508 | 2010-12-14 |
| 1578758223 | Susan Elizabeth Bennett | Counselor | 77 Mill St Ste 251, Westfield, MA 01085-5402 | 2007-09-06 |
| 1699968644 | Susan M Bennett | Social Worker | 1600 Osgood Street, Suite 3059, North Andover, MA 01845 | 2007-08-23 |
| 1649390386 | Susan G Bennett | Pharmacist | 8321 W Hammer Ln, Las Vegas, NV 89149-4606 | 2007-03-29 |
| 1518057744 | Susan Leah Bennett | Chiropractor | 121 N Union St, Olean, NY 14760 | 2006-10-16 |
| Street Address |
4915 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97217-3624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
| 1235643602 | Autism Outreach of Oregon | Occupational Therapist | 10350 N Vancouver Way #1043, Portland, OR 97217 | 2017-11-21 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1801282199 | Justine Osborn | Specialist | 4310 N. Interstate Ave, Portland, OR 97217 | 2015-04-13 |
| 1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
| 1295158186 | Rebecca Bulleri | Massage Therapist | 5416 N. Maryland Ave, Portland, OR 97217 | 2014-01-28 |
| 1659793107 | Shellmire Unlimited, P.C. | Community/Behavioral Health | 4134 N Vancouver Avenue, Suite 102, Portland, OR 97217 | 2014-01-16 |
| 1417207994 | Sportland Acupuncture LLC | Acupuncturist | 1025 N Humboldt, Portland, OR 97217 | 2012-09-12 |
| Find all providers in zip 97217 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477112480 | Stella Beatriz Kerl-mcclain | Psychologist | 2826 Sw Ridge Dr, Portland, OR 97219-6205 | 2019-06-12 |
| 1184281438 | Nicholas Alexander Schollars | Psychologist | 3050 Se Division St # 215, Portland, OR 97202-1451 | 2019-05-22 |
| 1639637432 | Bayside Psychology and Consulting, LLC | Psychologist | 1 Union St Ste 402, Portland, ME 04101-4048 | 2019-03-11 |
| 1942766985 | Alexandra R. Lash | Psychologist | 386 Fore St, Portland, ME 04101-4047 | 2019-02-14 |
| 1811416068 | Matthew Lundeberg | Psychologist | 10300 Sw Greenburg Rd Ste 271, Portland, OR 97223-5415 | 2017-09-19 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1093241838 | Dr Patricia Clark | Psychologist | 1132 Sw 19th Ave, Portland, OR 97205-1740 | 2017-05-11 |
| 1639527575 | Randall David Wright | Psychologist | 1827 Ne 44th Ave Ste 320, Portland, OR 97213-1443 | 2016-06-01 |
| Find all providers in PORTLAND | ||||
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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.