Provider Demographics
NPI:1396898391
Name:EICHENBERGER, SUSAN ABRAMS (EDD, LCSW)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ABRAMS
Last Name:EICHENBERGER
Suffix:
Gender:F
Credentials:EDD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2302
Mailing Address - Country:US
Mailing Address - Phone:502-635-7400
Mailing Address - Fax:502-423-1935
Practice Address - Street 1:8135 NEW LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4682
Practice Address - Country:US
Practice Address - Phone:502-451-7602
Practice Address - Fax:502-423-1935
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLCSW 3721041C0700X
KYLMFT 0128106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist