Provider Demographics
NPI:1083817860
Name:GARRETT, SUSAN G (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:G
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 VASSAR CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5752
Mailing Address - Country:US
Mailing Address - Phone:610-692-2655
Mailing Address - Fax:610-692-6203
Practice Address - Street 1:700 S HENDERSON RD
Practice Address - Street 2:SUITE 302B
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3530
Practice Address - Country:US
Practice Address - Phone:610-265-6464
Practice Address - Fax:610-337-0580
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0152541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491961Medicare ID - Type Unspecified