Provider Demographics
NPI:1669606661
Name:CLECK, SUZANNE MARIE (MSW LMSW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:CLECK
Suffix:
Gender:F
Credentials:MSW LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5240 PONTIAC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-2469
Mailing Address - Country:US
Mailing Address - Phone:248-421-1553
Mailing Address - Fax:
Practice Address - Street 1:7600 GRAND RIVER RD
Practice Address - Street 2:290
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7333
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010859511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical