Provider Demographics
NPI:1598169757
Name:SUSAN ANNE DANAHY, PH.D.
Entity Type:Organization
Organization Name:SUSAN ANNE DANAHY, PH.D.
Other - Org Name:SUSAN A. DANAHY, PH.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-478-2557
Mailing Address - Street 1:4400 BAYOU BLVD
Mailing Address - Street 2:BUILDING #51
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2673
Mailing Address - Country:US
Mailing Address - Phone:850-478-2557
Mailing Address - Fax:850-484-2875
Practice Address - Street 1:4400 BAYOU BLVD
Practice Address - Street 2:BUILDING #51
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2673
Practice Address - Country:US
Practice Address - Phone:850-478-2557
Practice Address - Fax:850-484-2875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3701103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL75806Medicare PIN