MEDICARE: SUSAN MCHUGH PHD

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	103T00000X	Psychologist	027941	NY
2	103K00000X	Behavior Analyst	001852	NY

General Provider Information

NPI Number	:	1477151215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MCHUGH PHD

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2215 BURDETT AVE
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12180-2466
Country	:	US
Telephone Number	:	518-833-6470
Fax Number	:	518-271-3682

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

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	06/11/2026

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