Provider Demographics
NPI:1205910833
Name:MORSE, SUSAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:MORSE
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 1:1 WASHINGTON AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482
Mailing Address - Country:US
Mailing Address - Phone:203-426-4701
Mailing Address - Fax:203-270-8335
Practice Address - Street 1:1 WASHINGTON AVE
Practice Address - Street 2:STE 4
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482
Practice Address - Country:US
Practice Address - Phone:203-426-4701
Practice Address - Fax:203-270-8335
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0044141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6256249OtherUNITED BEHAVIORAL HEALTH
CT140004414CT01OtherBLUE CROSS BLUE SHIELD