Provider Demographics
NPI:1154190759
Name:QUANSAH, SUSANNE (LMSW)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:QUANSAH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 TILDEN ST APT 14A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-6032
Mailing Address - Country:US
Mailing Address - Phone:917-715-4270
Mailing Address - Fax:
Practice Address - Street 1:801 TILDEN ST APT 14A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-6032
Practice Address - Country:US
Practice Address - Phone:917-715-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health