Provider Demographics
NPI:1366690075
Name:PIRSCH, SUSAN M (MC - LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:PIRSCH
Suffix:
Gender:F
Credentials:MC - LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 962
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-0962
Mailing Address - Country:US
Mailing Address - Phone:808-280-1150
Mailing Address - Fax:
Practice Address - Street 1:3669 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9546
Practice Address - Country:US
Practice Address - Phone:808-280-1150
Practice Address - Fax:808-280-1150
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
HI277106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist