MS. SUSAN POLLY STEVENS PSY.D.
NPI 1609932524
Psychologist in White River Junction, VT

Active since December 28, 2006Opted out of Medicare · through Apr 13, 2027
116D NCPTSD VAM ROC 215 NORTH MAIN ST, WHITE RIVER JUNCTION, VT 05009(802) 295-9363 Get Directions Write a Review

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

About Ms. Susan Polly Stevens Psy.d. NPPES

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

MS. SUSAN POLLY STEVENS PSY.D. (NPI 1609932524) is an individual psychologist in White River Junction, Vermont, licensed in New Hampshire (1109) and active in the NPI registry since December 2006. She has opted out of Medicare through April 13, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609932524
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMS. SUSAN POLLY STEVENSCredential: PSY.D.
Location Address116D NCPTSD VAM ROC 215 NORTH MAIN STWhite River Junction, VT 05009-0001
Mailing Address79 Kerwin Hill RdNorwich, VT 05055-9475 · (802) 296-5132
Sole ProprietorYes
Enumeration DateDecember 28, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1609932524 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 NH · 1109
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.

116D NCPTSD VAM ROC 215 NORTH MAIN ST, White River Junction, VT 05009

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Ms. Susan Polly Stevens Psy.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 13, 2017 through April 13, 2027.

Opt-Out Effective DateApril 13, 2017
Opt-Out In Effect ThroughApril 13, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609932524, enumerated as an "individual" on December 28, 2006.

The provider is located at 116D NCPTSD VAM ROC 215 NORTH MAIN ST WHITE RIVER JUNCTION, VT 05009 and the phone number is (802) 295-9363.

Psychologist with taxonomy code 103T00000X.