Provider Demographics
NPI:1477002772
Name:HOWARD, LAYNE SUZANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAYNE
Middle Name:SUZANNE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAYNE
Other - Middle Name:SUZANNE
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW, LISW
Mailing Address - Street 1:3422 N STONEYCREST RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-1744
Mailing Address - Country:US
Mailing Address - Phone:269-808-3651
Mailing Address - Fax:
Practice Address - Street 1:107 N STATE ROAD 135 STE 101
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1352
Practice Address - Country:US
Practice Address - Phone:317-473-1789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008645A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical