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General NPI Number Information
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NPI Number | 1558375394
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Entity Type | Individual
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Provider Name | SUSAN BURNS LISW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 501 PARK AVENUE
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City | HAMILTON
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State | OH
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Zip | 45013
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Country | US
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Telephone | 513-867-0676
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Fax | 513-867-0762
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Provider Business Mailing Address
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Address Line | 3200 BURNET AVENUE 1 RIDGEWAY
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-585-9009
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Fax | 513-585-9373
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10001960
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License Number State | OH
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