Provider Demographics
NPI:1588163760
Name:LAZARUS, SUZANNE GLAZER (LCSW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:GLAZER
Last Name:LAZARUS
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 1:2807 JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-7043
Mailing Address - Country:US
Mailing Address - Phone:504-237-5338
Mailing Address - Fax:
Practice Address - Street 1:3900 GENERAL TAYLOR ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-2915
Practice Address - Country:US
Practice Address - Phone:504-249-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical