Provider Demographics
NPI:1164897294
Name:PANTAS, SUSANNA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:PANTAS
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 1:356 BILTMORE AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4504
Mailing Address - Country:US
Mailing Address - Phone:828-254-2700
Mailing Address - Fax:828-254-1524
Practice Address - Street 1:356 BILTMORE AVE
Practice Address - Street 2:STE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4504
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:828-254-1524
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0112951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical