Provider Demographics
NPI:1962620831
Name:MCCARREL, SUSAN ABIGAIL (LCSW DCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ABIGAIL
Last Name:MCCARREL
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 1:24433 ROSEGATE PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1465
Mailing Address - Country:US
Mailing Address - Phone:626-755-4059
Mailing Address - Fax:
Practice Address - Street 1:236 E FOOTHILL BLVD STE C
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7518
Practice Address - Country:US
Practice Address - Phone:626-755-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS161291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical