Doctor Name: | MS. SUZANNE C IVANCIC |
NPI Number: | 1528192879 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R026427-1 |
Business Practice Address: | 53 West Main Street Honeoye Falls, NY - 14428 |
Business Phone Number: | 5856241540 |
Business Fax Number: | 5856247521 |
Mailing Address: | 381 Scottsville-chili Road, CHURCHVILLE |
State: | NY |
Postal Code: | 14428 |
Phone Number: | 5854555230 |
Fax Number: | 5856247521 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R026427-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |