Basic Information
| Provider Information | |||||||||
| NPI: | 1851497028 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARY | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 291943 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372291943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8339530829 | ||||||||
| FaxNumber: | 6152371434 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 CONGRESS ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011043564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137320040 | ||||||||
| FaxNumber: | 6152371434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 06/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A0401X | 420014270 | VT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 2084A0401X | C1-0012965 | DE | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 2084A0401X | 73294 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine |
ID Information
| ID | Type | State | Issuer | Description | 776407000 | 01 | MA | MAGELLAN INS GROUP # | OTHER | 000000029009 | 01 | MA | BMC HEALTHNET | OTHER | 2016082 | 01 | MA | CIGNA INS | OTHER | 3078540 | 05 | MA | MEDICAID | 208737000 | 01 | MA | MAGELLAN INS | OTHER | 542157023 | 01 | MA | UNITED BEH.HEALTH INS | OTHER | 586023 | 01 | MA | TUFTS INS GROUP # | OTHER | 775227 | 01 | MA | TUFTS INS | OTHER | 11091 | 01 | MA | HEALTH NEW ENGLAND INS | OTHER | 542157023 | 01 | MA | FEDERAL TAX ID | OTHER | M18872 | 01 | MA | BCBS INS GROUP# | OTHER |