Provider Demographics
NPI:1578762555
Name:HAGGAR, SUSAN M (LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:HAGGAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4436
Mailing Address - Country:US
Mailing Address - Phone:712-262-2922
Mailing Address - Fax:712-262-3826
Practice Address - Street 1:315 1ST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246-1543
Practice Address - Country:US
Practice Address - Phone:712-472-9605
Practice Address - Fax:712-472-3587
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker