THERESIA SUTHERLIN MD
NPI 1417416348
Psychiatry & Neurology - Child & Adolescent Psychiatry in Philadelphia, PA

Q: What is Theresia Sutherlin's NPI number?

The NPI number for Theresia Sutherlin is 1417416348. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Q: What is Theresia Sutherlin's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Active since March 19, 2019PECOS Enrolled

4601 MARKET ST FL 3, PHILADELPHIA, PA 19139(215) 590-6267 Get Directions Write a Review

NPPES record last updated: December 23, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 23, 2024, Nov 18, 2024, Mar 19, 2019 (3 updates tracked since 2019).

On this page

About Theresia Sutherlin Md NPPES

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

THERESIA SUTHERLIN MD (NPI 1417416348) is an individual child & adolescent psychiatry provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD487066) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Tulane University School Of Medicine (2019).

NPPES Registry Identity

NPI1417416348

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameTHERESIA SUTHERLINCredential: MD

Location Address4601 MARKET ST FL 3Philadelphia, PA 19139-4636

Mailing Address1430 Tulane Ave # 8055New Orleans, LA 70112-2632 · (504) 988-7829 · Fax (504) 988-4264

Phone(215) 590-6267

Sole ProprietorNo

Medical School CMSTulane University School Of MedicineGraduated 2019

Enumeration DateMarch 19, 2019

Last NPPES UpdateDecember 23, 20243 updates tracked since enumeration

NPPES CertifiedDecember 23, 2024

✔ NPI 1417416348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Licenses✔ Licensed in PA · MD487066✔ Licensed in LA · 336008

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4601 MARKET ST FL 3, Philadelphia, PA 19139

Open in Google Maps ↗

Secondary Practice Locations 2

Location 11430 Tulane Ave # 8055New Orleans, LA 70112-2632 · Phone (504) 988-7829 · Fax (504) 988-4264

Location 2111 Michigan Ave NWWashington, DC 20010-2916 · Phone (202) 476-3277

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresia Sutherlin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557897691

PECOS Enrollment IDI20251016003126

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.

Other Providers at the Same Location NPPES 19

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

CASEY LYNN GANZ-LEARY MA, LPC

Counselor (Professional)