Waldo, Susan Lauderdale
Waldo, Susan Lauderdale is an sole proprietor health care provider with primary practice located at 3904 Sw Windsong Dr , Lees Summit MO 64082-4051. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Waldo, Susan Lauderdale can be contacted via phone (660) 596-2400.Contact Information
Primary practice address
3904 Sw Windsong Dr
Lees Summit MO 64082-4051
Phone: (660) 596-2400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY01834 | Missouri |
Profile Details
| NPI number | 1174697338 |
|---|---|
| LBN Legal business name | Waldo, Susan Lauderdale |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Aug 27th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174697338 | NPPES |
| Missouri | Other | 25323025 | BLUE CROSS BLUE SHIELD ID |
| Missouri | MEDICAID | 498699511 | BLUE CROSS BLUE SHIELD ID |
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