Provider Demographics
NPI:1699797589
Name:SUTTENBERG, LAURIE PATLIN (LCSW, DCSW)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:PATLIN
Last Name:SUTTENBERG
Suffix:
Gender:F
Credentials:LCSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 ASHBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2817
Mailing Address - Country:US
Mailing Address - Phone:856-435-4793
Mailing Address - Fax:856-435-7901
Practice Address - Street 1:1999 MARLTON PIKE E
Practice Address - Street 2:SUITE 4
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1825
Practice Address - Country:US
Practice Address - Phone:856-435-4793
Practice Address - Fax:856-435-7901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC 043079001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical