Provider Demographics
NPI:1740051143
Name:SUZANNE ROEDER ALLEN, PLLC
Entity type:Organization
Organization Name:SUZANNE ROEDER ALLEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:ROEDER
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-260-6435
Mailing Address - Street 1:112 ROCK LEDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9827
Mailing Address - Country:US
Mailing Address - Phone:919-260-6435
Mailing Address - Fax:
Practice Address - Street 1:4 CONSULTANT PL UNIT 4B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6338
Practice Address - Country:US
Practice Address - Phone:919-260-6435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty