Provider Demographics
NPI:1831263466
Name:BERNSTEIN, SUSAN E (MSW LISW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25516 SHANNONDELL DR
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5683
Mailing Address - Country:US
Mailing Address - Phone:505-690-6605
Mailing Address - Fax:
Practice Address - Street 1:25516 SHANNONDELL DR
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-5683
Practice Address - Country:US
Practice Address - Phone:505-690-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-20991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical