Provider Demographics
NPI:1982930210
Name:ALGUIRE, SUSAN JEAN (LCSWR)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JEAN
Last Name:ALGUIRE
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 GREEN ST # 2
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3946
Mailing Address - Country:US
Mailing Address - Phone:315-796-4497
Mailing Address - Fax:315-797-6066
Practice Address - Street 1:1231 GREEN ST # 2
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3946
Practice Address - Country:US
Practice Address - Phone:315-796-4497
Practice Address - Fax:315-797-6066
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073659-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical