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General NPI Number Information
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NPI Number | 1477888626
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Entity Type | Organization
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Legal Business Name | SUSAN WARNER LLC
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 69 PEARCE AVE
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City | MANASQUAN
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State | NJ
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Zip | 08736-3008
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Country | US
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Telephone | 848-469-0433
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Fax | 732-612-3505
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Provider Business Mailing Address
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Address Line | 69 PEARCE AVE
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City | MANASQUAN
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State | NJ
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Zip | 08736-3008
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Country | US
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Telephone | 848-469-0433
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Fax | 732-612-3505
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN WARNER
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Credential | LCSW, LCADC
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Telephone | 848-469-0433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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