Provider Demographics
NPI:1740351295
Name:BYRD, SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3508
Mailing Address - Country:US
Mailing Address - Phone:415-419-3643
Mailing Address - Fax:415-491-7958
Practice Address - Street 1:2150 POST ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3508
Practice Address - Country:US
Practice Address - Phone:415-491-7960
Practice Address - Fax:415-491-7958
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS17142101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor