Provider Demographics
NPI:1912524497
Name:DANNER, SUZANNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:DANNER
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 1:5769 N HARCOURT DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8470
Mailing Address - Country:US
Mailing Address - Phone:208-659-0142
Mailing Address - Fax:
Practice Address - Street 1:1910 NORTHWEST BLVD STE 206
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2676
Practice Address - Country:US
Practice Address - Phone:208-659-0142
Practice Address - Fax:208-500-2707
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-433781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical