Provider Demographics
NPI:1346471992
Name:SCHNEIDER, SUSAN ROTH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ROTH
Last Name:SCHNEIDER
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 1:2 EAST AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2462
Mailing Address - Country:US
Mailing Address - Phone:914-833-2423
Mailing Address - Fax:
Practice Address - Street 1:2 EAST AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2462
Practice Address - Country:US
Practice Address - Phone:914-833-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR014686-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical