Provider Demographics
NPI:1467574822
Name:CHARNEY, SUSAN E (MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:CHARNEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:CHARNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:585 W END AVE
Mailing Address - Street 2:14D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1715
Mailing Address - Country:US
Mailing Address - Phone:212-799-7903
Mailing Address - Fax:212-799-7903
Practice Address - Street 1:585 W END AVE
Practice Address - Street 2:14D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1715
Practice Address - Country:US
Practice Address - Phone:212-799-7903
Practice Address - Fax:212-799-7903
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW81441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNO5661Medicare ID - Type Unspecified