Provider Demographics
NPI:1124274287
Name:CONCEICAO, SUSAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:CONCEICAO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10154 GROVE LOOP UNIT C
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6797
Mailing Address - Country:US
Mailing Address - Phone:646-338-9547
Mailing Address - Fax:
Practice Address - Street 1:10154 GROVE LOOP UNIT C
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6797
Practice Address - Country:US
Practice Address - Phone:646-338-9547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2021-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099231101041C0700X
NY61280641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR02987801OtherNYS LICENSE
CO09923110OtherCOLORADO LICENSE