Provider Demographics
NPI:1073730339
Name:EAKINS, SUSAN ELIZABETH ENGEL (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH ENGEL
Last Name:EAKINS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1198
Mailing Address - Country:US
Mailing Address - Phone:765-932-4111
Mailing Address - Fax:765-932-7505
Practice Address - Street 1:1264 S STATE ROAD 3
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-8509
Practice Address - Country:US
Practice Address - Phone:765-932-7010
Practice Address - Fax:765-932-7649
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005682A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN711000001Medicare PIN