Provider Demographics
NPI:1487723284
Name:LESSER, SUSAN F (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:F
Last Name:LESSER
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 1:12 ISLAND VIEW DR W
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-2913
Mailing Address - Country:US
Mailing Address - Phone:631-725-0072
Mailing Address - Fax:631-725-0072
Practice Address - Street 1:12 ISLAND VIEW DR W
Practice Address - Street 2:
Practice Address - City:SAG HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11963-2913
Practice Address - Country:US
Practice Address - Phone:631-725-0072
Practice Address - Fax:631-725-0072
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR038759-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical