Provider Demographics
NPI:1811262173
Name:CARTWRIGHT, SUSAN SMITH
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SMITH
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4682 N KENNY WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2277
Mailing Address - Country:US
Mailing Address - Phone:702-683-5954
Mailing Address - Fax:702-974-1700
Practice Address - Street 1:2921 N TENAYA WAY STE 117
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1412
Practice Address - Country:US
Practice Address - Phone:702-683-5954
Practice Address - Fax:702-974-1700
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0912106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist