Provider Demographics
NPI:1639906290
Name:HAUGH, SUSAN E (LSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:HAUGH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0S015 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-2523
Mailing Address - Country:US
Mailing Address - Phone:630-779-8275
Mailing Address - Fax:
Practice Address - Street 1:1804 N NAPER BLVD STE 250
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8830
Practice Address - Country:US
Practice Address - Phone:630-332-2358
Practice Address - Fax:630-283-8841
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108574104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker