Provider Demographics
NPI:1780862748
Name:KAMEN, SUSIE
Entity Type:Individual
Prefix:
First Name:SUSIE
Middle Name:
Last Name:KAMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SUSIE
Other - Middle Name:
Other - Last Name:KAMEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:37875 W 12 MILE RD
Mailing Address - Street 2:STE. 203
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3043
Mailing Address - Country:US
Mailing Address - Phone:248-788-7072
Mailing Address - Fax:
Practice Address - Street 1:37875 W 12 MILE RD
Practice Address - Street 2:STE. 203
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3043
Practice Address - Country:US
Practice Address - Phone:248-788-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical