Provider Demographics
NPI:1386959963
Name:DAVIS-MARSTERS, SUSAN LYNN (MA, NCC, CSW, LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNN
Last Name:DAVIS-MARSTERS
Suffix:
Gender:F
Credentials:MA, NCC, CSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 3RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1369
Mailing Address - Country:US
Mailing Address - Phone:609-915-1197
Mailing Address - Fax:609-372-4196
Practice Address - Street 1:33 THIRD ST FL 2
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-1369
Practice Address - Country:US
Practice Address - Phone:609-915-1197
Practice Address - Fax:609-372-4196
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW01356400104100000X
NJ37PC00175900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker