Provider Demographics
NPI:1487708517
Name:MCNARY, SUSAN DOROTHY (PHD ,MSED)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DOROTHY
Last Name:MCNARY
Suffix:
Gender:F
Credentials:PHD ,MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 VIA PINZON
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1557
Mailing Address - Country:US
Mailing Address - Phone:310-540-5340
Mailing Address - Fax:310-373-1163
Practice Address - Street 1:4433 VIA PINZON
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1557
Practice Address - Country:US
Practice Address - Phone:310-540-5340
Practice Address - Fax:310-373-1163
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT8591101YM0800X
CAPSY5364103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist