Provider Demographics
NPI:1699912766
Name:HEARD, SUZANNE L (LISW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:L
Last Name:HEARD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14476 E CARROLL BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4669
Mailing Address - Country:US
Mailing Address - Phone:216-255-6841
Mailing Address - Fax:
Practice Address - Street 1:797 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2440
Practice Address - Country:US
Practice Address - Phone:330-434-4514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00037431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical