Provider Demographics
NPI:1144241043
Name:CRICHTON, SUE (MSS LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:
Last Name:CRICHTON
Suffix:
Gender:F
Credentials:MSS LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 VALLEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2540
Mailing Address - Country:US
Mailing Address - Phone:302-475-4957
Mailing Address - Fax:302-475-4957
Practice Address - Street 1:2117 VALLEY AVENUE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-2540
Practice Address - Country:US
Practice Address - Phone:302-475-4957
Practice Address - Fax:302-475-4957
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100003851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
155313OtherVALUE OPTIONS
777877Medicare ID - Type Unspecified