DR. SUSAN HOLMES MCDANIEL PHD NPI 1003874207

NPI Information

NPI: 1003874207
Provider Name: DR. SUSAN HOLMES MCDANIEL, PHD
Classification:
Entity Type: Individual

PECOS Registration: Yes

Address:
777 S CLINTON AVE
ROCHESTER, NY
ZIP 14620
Phone: (585) 279-4820
Get Directions

DR. Susan Holmes Mcdaniel, PHD is a healthcare provider in Rochester, NY. DR. Susan Holmes Mcdaniel, PHD NPI is 1003874207. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

777 S CLINTON AVE
ROCHESTER, NY
ZIP 14620-401
Phone: (585) 279-4820
Fax: (585) 442-8319

The NPI 1003874207 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/4/2006 and was last updated on 7/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		6699	NEW YORK	No
2	103T00000X	Psychologist		0006699	NEW YORK	X
3	103TC0700X	Psychologist	Clinical	0006699	NEW YORK	X
4	103TC2200X	Psychologist	Clinical Child & Adolescent	0006699	NEW YORK	X
5	106H00000X	Marriage & Family Therapist				X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P010006699	OTHER	NEW YORK	BLUE CHOICE
2	711384	OTHER	NEW YORK	AETNA
3	MD431J	OTHER	NEW YORK	PREFERRED CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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