Provider Demographics
NPI:1558885145
Name:SUSANNA CAREW, PSY.D.
Entity Type:Organization
Organization Name:SUSANNA CAREW, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREW
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:856-258-7350
Mailing Address - Street 1:705 BIRCHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4013
Mailing Address - Country:US
Mailing Address - Phone:856-296-6273
Mailing Address - Fax:
Practice Address - Street 1:705 BIRCHFIELD DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4013
Practice Address - Country:US
Practice Address - Phone:856-258-7350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0555835Medicaid