| Susan Southworth, Psy.d. Llc | |
|
302 S Platte Clay Way Suite 103 Kearney MO 64060-8500 | |
| (816) 903-3800 | |
| (816) 903-9999 |
| Full Name | Susan Southworth, Psy.d. Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 302 S Platte Clay Way, Kearney, Missouri |
| Authorized Official Name and Position | Susan Marie Southworth (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8169033800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Southworth, Psy.d. Llc 302 S Clay Way Suite 103 Kearney MO 64060 Ph: (816) 903-3800 | Susan Southworth, Psy.d. Llc 302 S Platte Clay Way Suite 103 Kearney MO 64060-8500 Ph: (816) 903-3800 |
| NPI Number | 1750834701 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 07/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750834701 | NPI | - | NPPES |
| 1235313719 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 01928 (Missouri) | Primary |
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