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SUSAN SOUTHWORTH PSY.D. LLC NPI 1750834701


NPI Information

NPI: 1750834701
Provider Name: SUSAN SOUTHWORTH, PSY.D. LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
302 S PLATTE CLAY WAY
SUITE 103
KEARNEY, MO
ZIP 64060
Phone: (816) 903-3800
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SUSAN SOUTHWORTH, PSY.D. LLC is a clinical psychologist in Kearney, MO. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SUSAN SOUTHWORTH, PSY.D. LLC NPI is 1750834701. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

302 S PLATTE CLAY WAY
SUITE 103
KEARNEY, MO
ZIP 64060-500
Phone: (816) 903-3800
Fax: (816) 903-9999

The provider's authorized official is Susan Marie Southworth .
The authorized official title is Clinical Psychologist and has the following contact phone number (816) 903-3800.

The enumeration date for this NPI number is 7/26/2016 and was last updated on 7/26/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical01928MISSOURIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1D76000002MEDICARE PINMISSOURI
21235313719MEDICAIDMISSOURI

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

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