Provider Demographics
NPI:1922234665
Name:CALLAGHAN, SUZANNAH COLE (LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNAH
Middle Name:COLE
Last Name:CALLAGHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUZANNAH
Other - Middle Name:
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:668 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5904
Mailing Address - Country:US
Mailing Address - Phone:347-240-9406
Mailing Address - Fax:
Practice Address - Street 1:668 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5904
Practice Address - Country:US
Practice Address - Phone:347-240-9406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS730760781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical