Provider Demographics
NPI:1376165035
Name:JOYNER, SUSAN (LCSW-C, LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:JOYNER
Suffix:
Gender:X
Credentials:LCSW-C, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S B ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3936
Mailing Address - Country:US
Mailing Address - Phone:864-561-7039
Mailing Address - Fax:
Practice Address - Street 1:138 S B ST APT 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3936
Practice Address - Country:US
Practice Address - Phone:650-539-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD219931041C0700X
CA1112591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical