DR. SUSAN RUE WILSON ED.D.
NPI 1417061730
Psychologist - Clinical Child & Adolescent in Quincy, MA

Q: What is Susan Wilson's NPI number?

The NPI number for Susan Wilson is 1417061730. It was assigned to this individual provider in the NPPES registry on August 17, 2006.

Q: What is Susan Wilson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Susan Wilson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 17, 2006PECOS Enrolled

460 QUINCY AVE, QUINCY, MA 02169(617) 774-6070 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Susan Rue Wilson Ed.d. NPPES

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

DR. SUSAN RUE WILSON ED.D. (NPI 1417061730) is an individual clinical child & adolescent provider in Quincy, Massachusetts, licensed in Massachusetts (7554) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417061730

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. SUSAN RUE WILSONCredential: ED.D.

Location Address460 QUINCY AVEQuincy, MA 02169-8130

Mailing Address460 Quincy AveQuincy, MA 02169-8130 · (617) 774-6070

Phone(617) 774-6070

Sole ProprietorNo

Enumeration DateAugust 17, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1417061730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in MA · 7554

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

460 QUINCY AVE, Quincy, MA 02169

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Other Identifiers 1

Medicare ID-Type UnspecifiedWI W51158MA · Clinical Psychologist

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Susan Rue Wilson Ed.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.