Provider Demographics
NPI:1780454462
Name:LAMM, SUSANNA (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSANNA
Middle Name:
Last Name:LAMM
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:ROSENTHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:961 BROADWAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:961 BROADWAY
Practice Address - Street 2:SUITE 106
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598
Practice Address - Country:US
Practice Address - Phone:718-208-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-028942-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical