Provider Demographics
NPI:1003388554
Name:HEARSHEN, SUSAN FRIEDMAN (LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:FRIEDMAN
Last Name:HEARSHEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30224 ARDMORE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2120
Mailing Address - Country:US
Mailing Address - Phone:248-910-4474
Mailing Address - Fax:
Practice Address - Street 1:34505 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3258
Practice Address - Country:US
Practice Address - Phone:855-559-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010708111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical