Provider Demographics
NPI:1588007322
Name:BROWN-MANDEL, SUSAN JOY (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JOY
Last Name:BROWN-MANDEL
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:JOY
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3656 JOHNSON AVENUE SUITE 1F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:646-322-9086
Mailing Address - Fax:
Practice Address - Street 1:545 WEST 236TH STREET
Practice Address - Street 2:SUITE C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:646-322-9086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050199-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical