Doctor Name: | SUSAN HELEN HENNIGE |
NPI Number: | 1134116502 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LW 00008547 |
Business Practice Address: | 1602 E Seltice Way Suite D Post Falls, ID - 838547082 |
Business Phone Number: | 2086190190 |
Business Fax Number: | 2086190195 |
Mailing Address: | 1602 E. Seltice Way, Suite D POST FALLS |
State: | ID |
Postal Code: | 83854 |
Phone Number: | 2086190190 |
Fax Number: | 2086190190 |
NPI Enumeration Date: | 09/30/2005 |
NPI Last Update Date: | 06/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LW 00008547 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |