Provider Demographics
NPI:1598758872
Name:HOWARD, SUSAN COON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:COON
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2651
Mailing Address - Country:US
Mailing Address - Phone:203-753-8336
Mailing Address - Fax:203-753-7618
Practice Address - Street 1:1078 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2651
Practice Address - Country:US
Practice Address - Phone:203-753-8336
Practice Address - Fax:203-753-7618
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0010691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
135063OtherVALUE OPTIONS
197143OtherMHN
P377784OtherOXFORD HEALTH PLANS