Provider Demographics
NPI:1902606924
Name:KIERNAN, SUSAN ELIZABETH (LMHC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:KIERNAN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DAY ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-4505
Mailing Address - Country:US
Mailing Address - Phone:978-241-5536
Mailing Address - Fax:
Practice Address - Street 1:76 MERRIMACK ST STE 18
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6238
Practice Address - Country:US
Practice Address - Phone:978-214-2725
Practice Address - Fax:978-372-7150
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10003743101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health