Provider Demographics
NPI:1669520789
Name:HOREN, SUSAN A (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:A
Last Name:HOREN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 W 135TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-4844
Mailing Address - Country:US
Mailing Address - Phone:913-647-5210
Mailing Address - Fax:913-647-5214
Practice Address - Street 1:6240 W 135TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-4844
Practice Address - Country:US
Practice Address - Phone:913-647-5210
Practice Address - Fax:913-647-5214
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical