Provider Demographics
NPI:1598994873
Name:ENGEL, SUSAN (LCSW, MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TOWER LN
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4231
Mailing Address - Country:US
Mailing Address - Phone:860-269-3104
Mailing Address - Fax:860-269-3104
Practice Address - Street 1:30 TOWER LN
Practice Address - Street 2:4TH FLOOR
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4231
Practice Address - Country:US
Practice Address - Phone:860-269-3104
Practice Address - Fax:860-269-3104
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical