Provider Demographics
NPI:1316054281
Name:GAUS, SUSAN KAYE (MSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KAYE
Last Name:GAUS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR.
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4059
Mailing Address - Country:US
Mailing Address - Phone:304-623-3461
Mailing Address - Fax:304-626-7726
Practice Address - Street 1:LOUIS A. JOHNSON VAMC
Practice Address - Street 2:1 MEDICAL CENTER DRIVE
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-4059
Practice Address - Country:US
Practice Address - Phone:304-623-3461
Practice Address - Fax:304-626-7726
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00940744104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker