Provider Demographics
NPI:1790094480
Name:STRONG, SUSAN JOYCE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JOYCE
Last Name:STRONG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ARLENE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1454
Mailing Address - Country:US
Mailing Address - Phone:631-680-3663
Mailing Address - Fax:
Practice Address - Street 1:811 W JERICHO TPKE
Practice Address - Street 2:SUITE 106E
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3232
Practice Address - Country:US
Practice Address - Phone:631-265-9850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080404-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker