Provider Demographics
NPI:1841207701
Name:VESS, SUSAN T (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:T
Last Name:VESS
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 1:4521 JAMESTOWN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3234
Mailing Address - Country:US
Mailing Address - Phone:225-952-9210
Mailing Address - Fax:225-952-9214
Practice Address - Street 1:4521 JAMESTOWN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3234
Practice Address - Country:US
Practice Address - Phone:225-952-9210
Practice Address - Fax:225-952-9214
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2729101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health