Provider Demographics
NPI:1518100411
Name:GIRON, SUSAN (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:GIRON
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:PO BOX 5408
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71611-5408
Mailing Address - Country:US
Mailing Address - Phone:870-534-3386
Mailing Address - Fax:870-534-0350
Practice Address - Street 1:1202 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3020
Practice Address - Country:US
Practice Address - Phone:501-244-0622
Practice Address - Fax:501-244-0359
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-00551041C0700X
AR2563-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical