Provider Demographics
NPI:1760866446
Name:CARPENTER, SUZANNE KATHLEEN (ASW)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:KATHLEEN
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 COIT TOWER WAY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9412
Mailing Address - Country:US
Mailing Address - Phone:530-864-3285
Mailing Address - Fax:
Practice Address - Street 1:118 BELLE MILL RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2850
Practice Address - Country:US
Practice Address - Phone:530-840-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW82826104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker