MEDICARE: SUZANNE C ODDO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	179.030994	IL
2	1041C0700X	Clinical Social Worker	C019699	NC

General Provider Information

NPI Number	:	1902414824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE C ODDO LCSW

Provider Business Mailing Address
First Line	:	3123 BRUNSWICK AVE
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-4116
Country	:	US
Telephone Number	:	330-396-6627
Fax Number	:

Provider Business Practice Location Address
First Line	:	3123 BRUNSWICK AVE
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-4116
Country	:	US
Telephone Number	:	330-396-6627
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	03/11/2026

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Directions to “ SUZANNE C ODDO LCSW” Practice Location

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