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Individual

EMILY WYNN SUSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
227 N DIXIE WAY STE 125, SOUTH BEND, IN 46637-3385
(574) 276-7306
(574) 566-1236
Mailing address
52389 WINDOVER LN, GRANGER, IN 46530-9081
(508) 524-1790

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008383A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300128471
IN
Enumeration date
01/21/2019
Last updated
04/09/2026
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