Provider Demographics
NPI:1013072362
Name:HICKEY-MCNERNEY, SUSAN I
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:I
Last Name:HICKEY-MCNERNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:I
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWR, ACSW MSW
Mailing Address - Street 1:662 FARMERS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3114
Mailing Address - Country:US
Mailing Address - Phone:845-225-4932
Mailing Address - Fax:845-225-4932
Practice Address - Street 1:153 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2317
Practice Address - Country:US
Practice Address - Phone:845-494-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04913211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical