Provider Demographics
NPI:1417141474
Name:RAPPAPORT, SUSAN COOPER (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:COOPER
Last Name:RAPPAPORT
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OLD RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3032
Mailing Address - Country:US
Mailing Address - Phone:203-722-0976
Mailing Address - Fax:203-762-3827
Practice Address - Street 1:120 OLD RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3032
Practice Address - Country:US
Practice Address - Phone:203-722-0976
Practice Address - Fax:203-762-3827
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0045751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical