Doctor Name: | MRS. SUSAN MARCUS |
NPI Number: | 1043584568 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 34006426A |
Business Practice Address: | 9150 East 109th Street Crown Point, IN - 46307 |
Business Phone Number: | 2196899883 |
Business Fax Number: | |
Mailing Address: | 1910 Maplewood Ln, MUNSTER |
State: | IN |
Postal Code: | 463215156 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/01/2012 |
NPI Last Update Date: | 03/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34006426A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |