Provider Demographics
NPI:1316216963
Name:MICHNAY, SUSAN A (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:MICHNAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1407
Mailing Address - Country:US
Mailing Address - Phone:317-887-1348
Mailing Address - Fax:317-885-9063
Practice Address - Street 1:8920 SOUTHPOINTE DR STE E1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7505
Practice Address - Country:US
Practice Address - Phone:317-851-1004
Practice Address - Fax:317-386-7695
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004865A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty