| Doctor Name: | MS. SUSAN GRATHWOHL DINGLE |
| NPI Number: | 1578867677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, LMSW, CASAC |
| License Number: | 17192 |
| Business Practice Address: | 7400 New Suffolk Rd. New Suffolk, NY - 11956 |
| Business Phone Number: | 6317348658 |
| Business Fax Number: | |
| Mailing Address: | 7400 New Suffolk Rd., P.o. Box 56 NEW SUFFOLK |
| State: | NY |
| Postal Code: | 11956 |
| Phone Number: | 6317348658 |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2011 |
| NPI Last Update Date: | 01/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 17192 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |