DR. SUSAN LAUDERDALE WALDO (PH.D.) – Psychologist, NPI 1174697338

DR. SUSAN LAUDERDALE WALDO (PH.D.) is a healthcare provider. based in Lees summit, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PY01834 (MO). The NPI Number for DR. SUSAN LAUDERDALE WALDO (PH.D.) is 1174697338

Main info

Female
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUSAN LAUDERDALE WALDO (PH.D.)
NPI
1174697338
Phone
(660) 596-2400
Address
3904 SW WINDSONG DR
Enumeration Date
20 November 2006
Last Update Date
27 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6605962400
Graduation Year
1995 (31 years ago)
PAC ID
6103924089
Professional Enrollment ID
I20070531000598
Address ID
MO640824051LE3904XDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

Provider Addresses for DR. SUSAN LAUDERDALE WALDO (PH.D.)

  • 3904 SW WINDSONG DR

    LEES SUMMIT, MO 640824051

    Phone: (660) 596-2400

    Type: Location

  • Sedalia Post Office, 4195, West Douglas Avenue, Sedalia, Sedaila, Douglas County, Colorado, 80105, United States

    SEDALIA, MO 653021547

    Phone: (660) 826-5960

    Fax: (660) 826-4852

    Type: Mailing

  • 3948, West Condor Drive, Eagleridge Heights, Battlefield, Greene County, Missouri, 65619, United States

    BATTLEFIELD, MO 656199816

    Phone: (660) 596-2400

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-05-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070531000598IClinical PsychologistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64082)

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Provider's Procedures

DR. SUSAN LAUDERDALE WALDO (PH.D.) performs procedures in CLINICAL PSYCHOLOGIST. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHOLOGIST, CLINICALMO90853Group psychotherapy8411

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Frequently asked questions

What NPI should I save for DR. SUSAN LAUDERDALE WALDO (PH.D.)?
Save NPI 1174697338 if you need a stable reference for DR. SUSAN LAUDERDALE WALDO (PH.D.).
Is DR. SUSAN LAUDERDALE WALDO (PH.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DR. SUSAN LAUDERDALE WALDO (PH.D.)?
The page reflects Psychologist for DR. SUSAN LAUDERDALE WALDO (PH.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. SUSAN LAUDERDALE WALDO (PH.D.)?
The page summarizes Lees Summit, Missouri for DR. SUSAN LAUDERDALE WALDO (PH.D.); expand the address list for detail.
What if Lees Summit, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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