Provider Demographics
NPI:1740496538
Name:CREANGE, SUSAN J (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:CREANGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2723
Mailing Address - Country:US
Mailing Address - Phone:973-427-3255
Mailing Address - Fax:973-427-4442
Practice Address - Street 1:681 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2723
Practice Address - Country:US
Practice Address - Phone:973-427-3255
Practice Address - Fax:973-427-4442
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00460300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical