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General NPI Number Information
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NPI Number | 1194969683
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Entity Type | Individual
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Provider Name | SUSAN GORMAN L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 400 MORRIS AVE SUITE 214
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City | DENVILLE
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State | NJ
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Zip | 07834-1362
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Country | US
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Telephone | 201-874-8662
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Fax |
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Provider Business Mailing Address
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Address Line | 24 WHIPPOORWILL LN
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City | ROCKAWAY
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State | NJ
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Zip | 07866-4222
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Country | US
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Telephone | 201-874-8662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00390700
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License Number State | NJ
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