Provider Demographics
NPI:1275752206
Name:SUSIE HAIR, PLLC, LCSW
Entity Type:Organization
Organization Name:SUSIE HAIR, PLLC, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-732-9555
Mailing Address - Street 1:9604 PRESTON VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17430 CAMPBELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5212
Practice Address - Country:US
Practice Address - Phone:972-732-9555
Practice Address - Fax:972-250-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty