Provider Demographics
NPI:1831248160
Name:FRANK, SUSAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:FRANK
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 1:17 EAST 96 STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0783
Mailing Address - Country:US
Mailing Address - Phone:212-427-4193
Mailing Address - Fax:201-934-4883
Practice Address - Street 1:17 EAST 96 STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0783
Practice Address - Country:US
Practice Address - Phone:212-427-4193
Practice Address - Fax:201-934-4883
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO208311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
207506OtherMHN
7400199OtherGHI
NY146099OtherVALUE OPTION, INC.
NYN03041Medicare PIN