Provider Demographics
NPI:1821145418
Name:RESMAN, SUSAN P (LCSWR, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:P
Last Name:RESMAN
Suffix:
Gender:F
Credentials:LCSWR, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4184 SENECA ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3051
Mailing Address - Country:US
Mailing Address - Phone:716-675-4911
Mailing Address - Fax:716-675-4978
Practice Address - Street 1:4184 SENECA ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3051
Practice Address - Country:US
Practice Address - Phone:716-675-4911
Practice Address - Fax:716-675-4978
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0373421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY100078688001OtherAPS ID
NY000524103001OtherBC BS WNY ID
NY11824OtherENI ID
NY100078688001OtherAPS ID