Provider Demographics
NPI:1265556856
Name:URMETZ, SUSAN CHERYL (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:CHERYL
Last Name:URMETZ
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 1:3476 TWENTY MILE WAY
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-3202
Mailing Address - Country:US
Mailing Address - Phone:847-644-3687
Mailing Address - Fax:513-793-5054
Practice Address - Street 1:10597 MONTGOMERY RD STE 201
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4472
Practice Address - Country:US
Practice Address - Phone:847-644-3687
Practice Address - Fax:513-793-5054
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-004126103TC0700X
OHP.07792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL926952Medicare ID - Type Unspecified