Individual
SUSANNE JUDITH CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2200 W FAIRVIEW AVE, BOISE, ID 83702-6808
(208) 318-1363
(208) 205-8419
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 466-5359
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-27912
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518137546
—
ID
05
—
807782300
—
ID
Enumeration date
03/05/2008
Last updated
07/02/2025
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