Provider Demographics
NPI:1033403605
Name:GREWE, SUSAN M (LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:GREWE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1322 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-2803
Mailing Address - Country:US
Mailing Address - Phone:810-329-4798
Mailing Address - Fax:810-329-7303
Practice Address - Street 1:1322 N RIVER RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079-2803
Practice Address - Country:US
Practice Address - Phone:810-329-4798
Practice Address - Fax:810-329-7303
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010573401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical