Provider Demographics
NPI:1285677708
Name:LAWSON, SUSAN KAY (PHD, LICSW)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:KAY
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PHD, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 MAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ONA
Mailing Address - State:WV
Mailing Address - Zip Code:25545-9734
Mailing Address - Country:US
Mailing Address - Phone:304-962-6787
Mailing Address - Fax:
Practice Address - Street 1:3311 MAYWOOD DR
Practice Address - Street 2:
Practice Address - City:ONA
Practice Address - State:WV
Practice Address - Zip Code:25545-9734
Practice Address - Country:US
Practice Address - Phone:304-962-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009405111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical