Provider Demographics
NPI:1639309784
Name:SUANNE ZAGER, LMSW, INC.
Entity Type:Organization
Organization Name:SUANNE ZAGER, LMSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-593-9276
Mailing Address - Street 1:725 S ADAMS RD STE 235
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6931
Mailing Address - Country:US
Mailing Address - Phone:248-593-9276
Mailing Address - Fax:248-593-9276
Practice Address - Street 1:725 S ADAMS RD STE 235
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6931
Practice Address - Country:US
Practice Address - Phone:248-593-9276
Practice Address - Fax:248-593-9276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801046776251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI037967OtherBLUE CROSS
MI037967OtherBLUE CROSS