Provider Demographics
NPI:1073554093
Name:YORK, SUSAN BELL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BELL
Last Name:YORK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:HARRIS
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 DRAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443
Mailing Address - Country:US
Mailing Address - Phone:910-512-6985
Mailing Address - Fax:910-270-4546
Practice Address - Street 1:108 LAKESIDE DRIVE
Practice Address - Street 2:
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460
Practice Address - Country:US
Practice Address - Phone:910-512-6985
Practice Address - Fax:910-270-4546
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC000476104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002137Medicaid
NC6002137Medicaid