Provider Demographics
NPI:1811986482
Name:SPURLOCK, SUSANNE (MSW, LSW, ACSW)
Entity type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:
Last Name:SPURLOCK
Suffix:
Gender:F
Credentials:MSW, LSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 RED ROSE CT
Mailing Address - Street 2:SUITE301
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1981
Mailing Address - Country:US
Mailing Address - Phone:717-390-2636
Mailing Address - Fax:717-735-3902
Practice Address - Street 1:930 RED ROSE CT
Practice Address - Street 2:SUITE301
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1981
Practice Address - Country:US
Practice Address - Phone:717-390-2636
Practice Address - Fax:717-735-3902
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-009408L101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional