Provider Demographics
NPI:1417403064
Name:RAUNEGGER, SUSAN (LCSW 81670)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:RAUNEGGER
Suffix:
Gender:F
Credentials:LCSW 81670
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 REDWOOD ROAD SUITE 8
Mailing Address - Street 2:
Mailing Address - City:ST. HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574
Mailing Address - Country:US
Mailing Address - Phone:707-292-3126
Mailing Address - Fax:
Practice Address - Street 1:1360 GROVE CT
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1146
Practice Address - Country:US
Practice Address - Phone:707-292-3126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW603351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical