Provider Demographics
NPI:1457480709
Name:WARTUR, SUSAN LEYNER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LEYNER
Last Name:WARTUR
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 1:13778 75TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2816
Mailing Address - Country:US
Mailing Address - Phone:718-544-8586
Mailing Address - Fax:718-263-0097
Practice Address - Street 1:156 5TH AVE
Practice Address - Street 2:SUITE 534
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7002
Practice Address - Country:US
Practice Address - Phone:917-364-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health