Provider Demographics
NPI:1750408282
Name:REMMERS, SUSAN ELISE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELISE
Last Name:REMMERS
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 1:1574 COBURG RD. PMB 956
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2742
Mailing Address - Country:US
Mailing Address - Phone:541-343-7200
Mailing Address - Fax:844-364-4271
Practice Address - Street 1:240 COUNTRY CLUB RD STE B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2479
Practice Address - Country:US
Practice Address - Phone:541-343-7200
Practice Address - Fax:844-364-4271
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3244101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical