Provider Demographics
NPI:1316117484
Name:TOWNSEND, SUSAN M (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:M
Last Name:TOWNSEND
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 1:819 S SALINA ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3527
Mailing Address - Country:US
Mailing Address - Phone:315-417-7921
Mailing Address - Fax:315-474-1448
Practice Address - Street 1:819 S SALINA ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3527
Practice Address - Country:US
Practice Address - Phone:315-417-7921
Practice Address - Fax:315-474-1448
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076185172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker