Provider Demographics
NPI:1811973746
Name:ANDERSON, SUSAN JOY (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JOY
Last Name:ANDERSON
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:PO BOX 700326
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96709-0326
Mailing Address - Country:US
Mailing Address - Phone:808-433-8596
Mailing Address - Fax:
Practice Address - Street 1:BLDG. 687, SCHOFIELD BARRACKS
Practice Address - Street 2:SOLDIER ASSISTANCE CENTER, US ARMY HEALTH CLINIC
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-433-8596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALWOOOO59351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical