Provider Demographics
NPI:1275733578
Name:WAYN, SUSAN BELINDA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:BELINDA
Last Name:WAYN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3003
Mailing Address - Country:US
Mailing Address - Phone:914-948-8004
Mailing Address - Fax:914-289-0566
Practice Address - Street 1:1 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-3003
Practice Address - Country:US
Practice Address - Phone:914-948-8004
Practice Address - Fax:914-289-0566
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0533831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical