Provider Demographics
NPI:1265425722
Name:GRIERSON, SUZANNE LEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LEE
Last Name:GRIERSON
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 1:67 OAK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-8225
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1258 PURDYTOWN TPKE
Practice Address - Street 2:SUITE 2
Practice Address - City:LAKEVILLE
Practice Address - State:PA
Practice Address - Zip Code:18438-6793
Practice Address - Country:US
Practice Address - Phone:570-226-4444
Practice Address - Fax:570-226-4333
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014961104100000X
NJSC047919104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPTAN 160320Medicaid
PA160320Medicare PIN
PA1192405M7Medicare UPIN