Provider Demographics
NPI:1245399377
Name:POSEY, SUSIE KAISER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUSIE
Middle Name:KAISER
Last Name:POSEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 TAYLOR DRAPER LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3916
Mailing Address - Country:US
Mailing Address - Phone:512-343-8850
Mailing Address - Fax:512-949-8079
Practice Address - Street 1:11211 TAYLOR DRAPER LN
Practice Address - Street 2:SUITE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3916
Practice Address - Country:US
Practice Address - Phone:512-343-8850
Practice Address - Fax:512-343-8079
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33849103TC0700X
MO2006027462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO496287202Medicaid
MO496287202Medicaid
TX8K5118Medicare PIN