Provider Demographics
NPI:1760678122
Name:ALBRIGHT, SUSAN HAYDEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:HAYDEN
Last Name:ALBRIGHT
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 1:501 BAY AVENUE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2553
Mailing Address - Country:US
Mailing Address - Phone:609-926-4644
Mailing Address - Fax:609-926-6855
Practice Address - Street 1:501 BAY AVENUE
Practice Address - Street 2:SUITE 105
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2553
Practice Address - Country:US
Practice Address - Phone:609-926-4644
Practice Address - Fax:609-926-6855
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002997001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ629534Medicare PIN