Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Susan Vivian Jacob, PHD

Individual provider Clinical Child & Adolescent Psychologist · NPI 1467675819

Dr. Susan Vivian Jacob, PHD is a Clinical Child & Adolescent Psychologist in Port Washington, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

14 Vanderventer Ave
Port Washington, NY 11050-3737
Phone: (516) 944-3786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Child & Adolescent Psychologist (primary) Taxonomy 103TC2200X · Licence 0077981 (NY)

Record details

NPI number1467675819
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedApril 11, 2007
Last updated in NPPESJuly 8, 2007

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