Provider Demographics
NPI:1164667390
Name:SINGLETON, SUE CAROL (LCSW)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:CAROL
Last Name:SINGLETON
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 1:818 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31768-5518
Mailing Address - Country:US
Mailing Address - Phone:229-454-6496
Mailing Address - Fax:
Practice Address - Street 1:1834A JACLIF CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4400
Practice Address - Country:US
Practice Address - Phone:850-681-6001
Practice Address - Fax:850-681-6003
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW56791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL765562200Medicaid