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General NPI Number Information
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NPI Number | 1780899583
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Entity Type | Individual
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Provider Name | SUZE MARIE MAZE LCSW, CCGC, CEAP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 2331 FORTUNE DR SUITE 205
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City | LEXINGTON
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State | KY
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Zip | 40509-4110
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Country | US
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Telephone | 859-421-5831
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Fax | 859-402-8084
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Provider Business Mailing Address
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Address Line | 2456 EDGEFIELD HWY
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City | AIKEN
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State | SC
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Zip | 29801-8018
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Country | US
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Telephone | 803-646-1487
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Fax | 803-646-1487
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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 | 9615
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License Number State | SC
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