Provider Demographics
NPI:1851497028
Name:CARY, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:CARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291943
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1943
Mailing Address - Country:US
Mailing Address - Phone:833-953-0829
Mailing Address - Fax:615-237-1434
Practice Address - Street 1:80 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3564
Practice Address - Country:US
Practice Address - Phone:413-732-0040
Practice Address - Fax:615-237-1434
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT4200142702084A0401X
DEC1-00129652084A0401X
MA732942084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA776407000OtherMAGELLAN INS GROUP #
MA000000029009OtherBMC HEALTHNET
MA2016082OtherCIGNA INS
MA3078540Medicaid
MA208737000OtherMAGELLAN INS
MA542157023OtherUNITED BEH.HEALTH INS
MA586023OtherTUFTS INS GROUP #
MA775227OtherTUFTS INS
MA11091OtherHEALTH NEW ENGLAND INS
MA542157023OtherFEDERAL TAX ID
MAM18872OtherBCBS INS GROUP#
MA11091OtherHEALTH NEW ENGLAND INS