Provider Demographics
NPI:1891827481
Name:SUSSAN, KAREN (LMHC, LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:SUSSAN
Suffix:
Gender:F
Credentials:LMHC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MONTEBELLO RD STE 6-C
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3746
Mailing Address - Country:US
Mailing Address - Phone:845-533-2788
Mailing Address - Fax:
Practice Address - Street 1:75 MONTEBELLO RD STE 6-C
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-3746
Practice Address - Country:US
Practice Address - Phone:845-533-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
NY001633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker