Provider Demographics
NPI:1346785912
Name:CARY, SUZANNE MICHELLE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MICHELLE
Last Name:CARY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:MICHELLE
Other - Last Name:SEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1662
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-1662
Mailing Address - Country:US
Mailing Address - Phone:573-886-7422
Mailing Address - Fax:573-814-1557
Practice Address - Street 1:701 VANDIVER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-2094
Practice Address - Country:US
Practice Address - Phone:573-886-7422
Practice Address - Fax:573-814-1557
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0059571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical