Individual
SUSAN DIANE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
318 PINE LAKE AVE, LA PORTE, IN 46350-3061
(219) 324-6263
Mailing address
PO BOX 668, LA PORTE, IN 46352-0668
(219) 324-6263
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34000100
IN
1041C0700X
Clinical Social Worker
34000100
IN
Other
Enumeration date
08/20/2006
Last updated
09/11/2025
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