Provider Demographics
NPI:1376652842
Name:HUTCHINSON, SUSAN C (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:C
Other - Last Name:MITTENDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3520 GENERAL DE GAULLE DR
Mailing Address - Street 2:#4098
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6757
Mailing Address - Country:US
Mailing Address - Phone:504-362-8046
Mailing Address - Fax:
Practice Address - Street 1:3520 GENERAL DE GAULLE DR
Practice Address - Street 2:#4098
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6757
Practice Address - Country:US
Practice Address - Phone:504-362-8046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical