DR. SUSAN DEAN ODOM PH.D.
NPI 1043481195
Psychologist in San Antonio, TX

Active since March 17, 2008Opted out of Medicare · through Apr 1, 2027
13423 BLANCO RD UNIT 803, SAN ANTONIO, TX 78216(210) 689-1100 Get Directions Write a Review

NPPES record last updated: May 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 17, 2023, Mar 23, 2023, Mar 17, 2023 and 1 more (4 updates tracked since 2023).

About Dr. Susan Dean Odom Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN DEAN ODOM PH.D. (NPI 1043481195) is an individual psychologist in San Antonio, Texas, licensed in Texas (33728) and active in the NPI registry since March 2008. She has opted out of Medicare through April 1, 2027.

NPPES Registry Identity

NPI1043481195
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SUSAN DEAN ODOMCredential: PH.D.
Location Address13423 BLANCO RD UNIT 803San Antonio, TX 78216-2187
Mailing Address13423 Blanco Rd Unit 803San Antonio, TX 78216-2187 · (210) 557-2266 · Fax (210) 624-8789
Sole ProprietorYes
Enumeration DateMarch 17, 2008
Last NPPES UpdateMay 17, 20234 updates tracked since enumeration
NPPES CertifiedMay 17, 2023
NPI 1043481195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in TX · 33728
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License 33728 (TX)
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 33728 (TX)
Also ListedPsychologist · HealthTaxonomy 103TH0004X · License 33728 (TX)
13423 BLANCO RD UNIT 803, San Antonio, TX 78216

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Susan Dean Odom Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2025 through April 1, 2027.

Opt-Out Effective DateApril 1, 2025
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Odom's NPI number?

The NPI number for Susan Odom is 1043481195. It was assigned to this individual provider in the NPPES registry on March 17, 2008.

Where is Susan Odom located?

Susan Odom practices at 13423 Blanco Rd Unit 803, San Antonio, TX 78216. The listed phone number is (210) 689-1100.

What is Susan Odom's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Susan Odom enrolled in Medicare?

No. Susan Odom has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Susan Odom was last updated on May 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.