MEDICARE: DR. KATHY LYNN ACUS-SOUDERS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	5311	OH

General Provider Information

NPI Number	:	1174523070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHY LYNN ACUS-SOUDERS PSY.D.

Provider Business Mailing Address
First Line	:	7 WHIPPOORWILL CT
Second Line	:
City	:	ENON
State	:	OH
Zip	:	45323-9792
Country	:	US
Telephone Number	:	937-864-1940
Fax Number	:	937-864-1950

Provider Business Practice Location Address
First Line	:	2188 GATEWAY DR
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-6356
Country	:	US
Telephone Number	:	937-864-7122
Fax Number	:	937-864-1950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/16/2008

Similar Medicare Providers

1356333678 — CECILIA JACOBS PSY.D.
Practice Location Address:

2188 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-320-5859
Practice Fax: 937-426-1349

1598730657 — OSCAR BLAS CATALDI JR. M.D.
Practice Location Address:

2180 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-208-8155
Practice Fax: 937-208-8140

1740233279 — MVHE INC
Practice Location Address:

2180 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-208-8155
Practice Fax: 937-208-8140

1356427223 — ANESSA D ALAPPATT MD
Practice Location Address:

2180 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-208-8155
Practice Fax: 937-208-8140

1780899633 — GEETHA C AMBALAVANAN MD
Practice Location Address:

2180 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-208-8155
Practice Fax: 937-208-8140

1215112214 — KATHY ACUS-SOUDERS, PSY.D., LLC
Practice Location Address:

2188 GATEWAY DR
FAIRBORN, OH
45324-6356

Practice Phone: 937-864-1940
Practice Fax: 937-864-1950

Directions to “ DR. KATHY LYNN ACUS-SOUDERS PSY.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.