Provider Demographics
NPI:1225549553
Name:KEARNEY, SUSAN C (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:C
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12192 MESA VERDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4879
Mailing Address - Country:US
Mailing Address - Phone:512-294-9537
Mailing Address - Fax:
Practice Address - Street 1:813 W 11TH ST STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2058
Practice Address - Country:US
Practice Address - Phone:512-294-9537
Practice Address - Fax:512-727-0993
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical