Provider Demographics
NPI:1962508234
Name:STEINHART, SUSAN S (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:STEINHART
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 1:274 DELAWARE AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1439
Mailing Address - Country:US
Mailing Address - Phone:518-439-2743
Mailing Address - Fax:518-439-2792
Practice Address - Street 1:274 DELAWARE AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1439
Practice Address - Country:US
Practice Address - Phone:518-439-2743
Practice Address - Fax:518-439-2792
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0117021104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01423610Medicaid
NYST53504BMedicare ID - Type Unspecified
56929Medicare UPIN