Provider Demographics
NPI:1811454119
Name:RINK, SUSAN ELLEN (LSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELLEN
Last Name:RINK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-3249
Mailing Address - Country:US
Mailing Address - Phone:215-249-4836
Mailing Address - Fax:
Practice Address - Street 1:325 FOREST RD
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-3249
Practice Address - Country:US
Practice Address - Phone:215-249-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130907104100000X
PACW021174104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty