DR. VIJAYALAKSHMI SUSARLA PH.D
NPI 1417067190
Psychologist in Darien, IL

Active since August 30, 2006Opted out of Medicare · through Dec 16, 2027
2628 83RD ST, DARIEN, IL 60561(630) 246-6810(630) 246-6809 Get Directions Write a Review

NPPES record last updated: December 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Vijayalakshmi Susarla Ph.d NPPES

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

DR. VIJAYALAKSHMI SUSARLA PH.D (NPI 1417067190) is an individual psychologist in Darien, Illinois, licensed in Illinois (071005075) and active in the NPI registry since August 2006. She has opted out of Medicare through December 16, 2027.

NPPES Registry Identity

NPI1417067190
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. VIJAYALAKSHMI SUSARLACredential: PH.D
Location Address2628 83RD STDarien, IL 60561-1661
Mailing Address632 Conestoga RdNaperville, IL 60563-2491 · (630) 975-1610 · Fax (630) 246-6809
Fax(630) 246-6809
Sole ProprietorYes
Enumeration DateAugust 30, 2006
Last NPPES UpdateDecember 11, 2013
NPI 1417067190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071005075
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.
2628 83RD ST, Darien, IL 60561

Other Identifiers 1

Medicare ID-Type UnspecifiedK05522IL

Accepted Insurance

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. Vijayalakshmi Susarla 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 December 16, 2023 through December 16, 2027.

Opt-Out Effective DateDecember 16, 2023
Opt-Out In Effect ThroughDecember 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor
2628 83RD ST
DARIEN, IL 60561
Psychologist (Clinical)
2628 83RD ST
DARIEN, IL 60561
Counselor (Professional)
2628 83RD ST
DARIEN, IL 60561

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 Vijayalakshmi Susarla's NPI number?

The NPI number for Vijayalakshmi Susarla is 1417067190. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Vijayalakshmi Susarla located?

Vijayalakshmi Susarla practices at 2628 83rd St, Darien, IL 60561. The listed phone number is (630) 246-6810.

What is Vijayalakshmi Susarla's specialty?

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

Is Vijayalakshmi Susarla enrolled in Medicare?

No. Vijayalakshmi Susarla has opted out of Medicare through December 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Vijayalakshmi Susarla accept?

Health plans from Providence Health Plan list Vijayalakshmi Susarla as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vijayalakshmi Susarla was last updated on December 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.