Healthcare Provider Details

I. General information

NPI: 1326007600
Provider Name (Legal Business Name): SUSANNE L FRANZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FT CARSON CO
80913-4603
US

IV. Provider business mailing address

1650 COCHRANE CIR
FT CARSON CO
80913-4603
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-1385
  • Fax: 719-524-1308
Mailing address:
  • Phone: 719-524-1385
  • Fax: 719-524-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991719
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier991719
Identifier TypeOTHER
Identifier StateCO
Identifier IssuerLCSW

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: