Provider Demographics
NPI:1477634723
Name:HART, SUSAN DANIELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:DANIELLE
Last Name:HART
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 1:106 OLD HOOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2400
Mailing Address - Country:US
Mailing Address - Phone:201-666-2400
Mailing Address - Fax:201-666-2334
Practice Address - Street 1:106 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2400
Practice Address - Country:US
Practice Address - Phone:201-666-2400
Practice Address - Fax:201-666-2334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health