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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. SUSAN ELIZABETH WILLIS PH.D.
NPI 1689627945
Psychologist - Clinical in Winston-salem, NC

Active since May 18, 2006
1066 W 4TH ST, WINSTON-SALEM, NC 27101(336) 723-3155(336) 734-1188 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Susan Elizabeth Willis Ph.d. NPPES

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

DR. SUSAN ELIZABETH WILLIS PH.D. (NPI 1689627945) is an individual clinical provider in Winston-salem, North Carolina, licensed in North Carolina (1370) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1689627945
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. SUSAN ELIZABETH WILLISCredential: PH.D.
Location Address1066 W 4TH STWinston-salem, NC 27101-2434
Mailing Address1066 W 4th StWinston-salem, NC 27101-2434 · (336) 723-3155 · Fax (336) 734-1188
Phone(336) 723-3155
Fax(336) 734-1188
Sole ProprietorNo
Enumeration DateMay 18, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1689627945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NC · 1370
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1066 W 4TH ST, Winston-salem, NC 27101
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Other Identifiers 3

Other0490CNC · Bcbs
Other281962NC · Valueoptions
Other14751863NC · United Behavioral Service

Other Providers at the Same Location NPPES 2

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

AMANDA BECK COUNSELING COACHING AND CONSULTATION
Counselor (Mental Health)
1066 W 4TH ST
WINSTON SALEM, NC 27101
Forsyth County (336) 863-6438
FULL LIFE COUNSELING, PLLC
Community/Behavioral Health
1066 W 4TH ST, SUITE 201
WINSTON SALEM, NC 27101
Forsyth County (336) 923-7426

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 Willis's NPI number?

The NPI number for Susan Willis is 1689627945. It was assigned to this individual provider in the NPPES registry on May 18, 2006.

Where is Susan Willis located?

Susan Willis practices at 1066 W 4th St, Winston-Salem, NC 27101. The listed phone number is (336) 723-3155.

What is Susan Willis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Susan Willis was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.