IndividualActive
Paul Susic, MA
NPI 1790707123 · Health Service Psychologist · St. Charles, MO
Provider details
- NPI number
- 1790707123
- Entity type
- Individual
- Primary specialty
- Health Service PsychologistBehavioral Health & Social Service Providers
- Credential
- MA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 01802 (MO)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2451 Executive Dr. Ste. 103
St. Charles, MO 63303
Phone: (636) 300-9922
Approximate (ZIP-level) locationGet directions
Mailing address
350 Trailhead Way
Dardenne Prairie, MO 63368
Registry dates
- Enumerated
- 2006-07-24
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.