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Individual

SUSAN M EXWORTHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW CSAC

Contact information

Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15999-132
WI
1041C0700X
Clinical Social Worker
Primary
8922-123
WI

Other

Enumeration date
04/02/2015
Last updated
11/09/2021
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