| Doctor Name: | RICHARD SUSNER |
| NPI Number: | 1225425960 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW |
| License Number: | I.1302885 |
| Business Practice Address: | 43 E Main St Amelia, OH - 451021993 |
| Business Phone Number: | 5139477000 |
| Business Fax Number: | 5139477001 |
| Mailing Address: | 43 E Main St, AMELIA |
| State: | OH |
| Postal Code: | 451021993 |
| Phone Number: | 5139477000 |
| Fax Number: | 5139477001 |
| NPI Enumeration Date: | 04/21/2015 |
| NPI Last Update Date: | 04/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I.1302885 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |