Paul Lynn Susic, MA is a medicare enrolled "Psychologist - Health Service" provider in St. Charles, Missouri. His current practice location is
2451 Executive Dr. Ste. 103, St. Charles, Missouri. You can reach out to his office (for appointments etc.) via phone at
(636) 300-9922.
Paul Lynn Susic is licensed to practice in Missouri (license number 01802) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790707123.
Healthcare Provider's Profile
Full Name | Paul Lynn Susic |
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Gender | Male |
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Speciality | Psychologist - Health Service |
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Location | 2451 Executive Dr. Ste. 103, St. Charles, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790707123
- Provider Enumeration Date: 07/24/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 9234105123
- Enrollment ID: I20041007000266
Medical Identifiers
Medical identifiers for Paul Lynn Susic such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790707123 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TH0100X | Psychologist - Health Service | 01802 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Paul Lynn Susic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Paul Lynn Susic, MA 350 Trailhead Way, Dardenne Prairie, MO 63368 Ph: (636) 300-9922 | Paul Lynn Susic, MA 2451 Executive Dr. Ste. 103, St. Charles, MO 63303 Ph: (636) 300-9922 |
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