Provider Demographics
NPI:1508913658
Name:BIRNE-STONE, SUSAN (PHD,LCSW)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:BIRNE-STONE
Suffix:
Gender:F
Credentials:PHD,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NEPTUNE AVE
Mailing Address - Street 2:APT 14D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4063
Mailing Address - Country:US
Mailing Address - Phone:718-946-9091
Mailing Address - Fax:
Practice Address - Street 1:172 GRAVESEND NECK RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4745
Practice Address - Country:US
Practice Address - Phone:917-841-0169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0313971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical