Provider Demographics
NPI:1508059064
Name:SMITH, SUSAN BRATCHER (LCSW, ICAADC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BRATCHER
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW, ICAADC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ADAMS
Other - Last Name:KILMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ADAMS: KILMAN
Mailing Address - Street 1:1090 ARNOLD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK AFB
Mailing Address - State:AR
Mailing Address - Zip Code:72099-4933
Mailing Address - Country:US
Mailing Address - Phone:501-987-4820
Mailing Address - Fax:
Practice Address - Street 1:1090 ARNOLD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK AFB
Practice Address - State:AR
Practice Address - Zip Code:72099-4933
Practice Address - Country:US
Practice Address - Phone:501-987-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA-020101YA0400X
TX687131041C0700X
AR1571-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)