Provider Demographics
NPI:1396824405
Name:CAREY, SUSAN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:CAREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 N COLLINS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2698
Mailing Address - Country:US
Mailing Address - Phone:972-437-4698
Mailing Address - Fax:972-671-2087
Practice Address - Street 1:22010 17TH AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8486
Practice Address - Country:US
Practice Address - Phone:425-487-3885
Practice Address - Fax:425-487-4884
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002496103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist