Provider Demographics
NPI:1578746491
Name:MALEKI, SUESAN (LSW)
Entity Type:Individual
Prefix:
First Name:SUESAN
Middle Name:
Last Name:MALEKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 PLUS PARK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-1277
Mailing Address - Country:US
Mailing Address - Phone:615-467-7502
Mailing Address - Fax:615-781-9408
Practice Address - Street 1:299 PLUS PARK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-1277
Practice Address - Country:US
Practice Address - Phone:615-467-7502
Practice Address - Fax:615-781-9408
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW44251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical