Provider Demographics
NPI:1033494950
Name:FARKAS, SUSAN WERTHEIM (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:WERTHEIM
Last Name:FARKAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ABBEY LN
Mailing Address - Street 2:DEPARTMENT OF SPECIAL EDUCATION
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-4042
Mailing Address - Country:US
Mailing Address - Phone:516-520-8300
Mailing Address - Fax:516-520-8367
Practice Address - Street 1:150 ABBEY LN
Practice Address - Street 2:DEPARTMENT OF SPECIAL EDUCATION
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4042
Practice Address - Country:US
Practice Address - Phone:516-520-8300
Practice Address - Fax:516-520-8367
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020777R104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker