Provider Demographics
NPI:1932181955
Name:RIZER, SUSAN L (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:RIZER
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 1:2812 CUMBERLAND DR
Mailing Address - Street 2:APT. 3H
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2532
Mailing Address - Country:US
Mailing Address - Phone:219-531-0294
Mailing Address - Fax:
Practice Address - Street 1:601 WALL ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2512
Practice Address - Country:US
Practice Address - Phone:219-762-9557
Practice Address - Fax:219-462-3975
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003485A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000207917OtherANTHEM
IN34003485AOtherLCSW
IN34003485AOtherLCSW
IN659590BMedicare ID - Type Unspecified