Provider Demographics
NPI:1386934156
Name:ABERCROMBIE, SUZANNE ALICIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ALICIA
Last Name:ABERCROMBIE
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 1:12546 RAPIDS PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4100
Mailing Address - Country:US
Mailing Address - Phone:423-283-4012
Mailing Address - Fax:
Practice Address - Street 1:12546 RAPIDS PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4100
Practice Address - Country:US
Practice Address - Phone:423-283-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538811041C0700X
LA100611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical