Provider Demographics
NPI:1063966927
Name:EMERSON, SUSAN J (MED, LMFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-4141
Mailing Address - Country:US
Mailing Address - Phone:508-951-6266
Mailing Address - Fax:973-267-0380
Practice Address - Street 1:500 MORRIS AVE STE 313
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1020
Practice Address - Country:US
Practice Address - Phone:508-951-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100180100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist