Provider Demographics
NPI:1013746239
Name:NEWMAN, SUSAN GAIL (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:GAIL
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:ROLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8033 DELTA DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-6710
Mailing Address - Country:US
Mailing Address - Phone:850-533-2479
Mailing Address - Fax:
Practice Address - Street 1:8033 DELTA DR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32583-6710
Practice Address - Country:US
Practice Address - Phone:850-533-2479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW187151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical