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Individual
SUZANNE J ENNIS
Active
Individual
SUZANNE J ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR026735
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008022
VALUE OPTIONS
NY
05
—
01658364
—
NY
01
—
1052640
BEACON HEALTH STRATEGIES
NY
01
—
12362
VYTRA
NY
01
—
182262
GUARDIAN PHS
NY
01
—
5861327
AETNA
NY
01
—
N1432
EMPIRE BLUE CROSS
NY
01
—
P2552029
OXFORD
NY
Enumeration date
08/01/2006
Last updated
07/08/2007
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