Provider Demographics
NPI:1356449839
Name:HAFFERT, SUSAN N (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:N
Last Name:HAFFERT
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 1:1999 MARLTON PIKE E
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1825
Mailing Address - Country:US
Mailing Address - Phone:856-489-8300
Mailing Address - Fax:856-429-1256
Practice Address - Street 1:1999 MARLTON PIKE E
Practice Address - Street 2:SUITE 4
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1825
Practice Address - Country:US
Practice Address - Phone:856-489-8300
Practice Address - Fax:856-429-1256
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003007001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical