Healthcare Provider Details

I. General information

NPI: 1982623013
Provider Name (Legal Business Name): SUSAN LYNN COMPTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUE COMPTON LCSW

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 US HIGHWAY 1 SUITE 11
JUNO BEACH FL
33408-1612
US

IV. Provider business mailing address

13901 US HIGHWAY 1 SUITE 11
JUNO BEACH FL
33408-1612
US

V. Phone/Fax

Practice location:
  • Phone: 561-624-4748
  • Fax: 561-624-4772
Mailing address:
  • Phone: 561-624-4748
  • Fax: 561-624-4772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW3327
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: