Ennis, Suzanne J

Ennis, Suzanne J is an sole proprietor health care provider with primary practice located at 5 Blueberry Ridge Rd , Setauket NY 11733-1503. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ennis, Suzanne J can be contacted via phone (631) 689-8578.

Contact Information

Primary practice address
5 Blueberry Ridge Rd Setauket NY 11733-1503
Phone: (631) 689-8578
Fax: (631) 689-8578
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X PR026735 New York

Profile Details

NPI number 1912914383
LBN Legal business name Ennis, Suzanne J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912914383 NPPES
New York Other 0008022 VALUE OPTIONS
New York Other 0008022 VALUE OPTIONS
New York MEDICAID 01658364 VALUE OPTIONS
New York Other 1052640 VALUE OPTIONS
New York Other P2552029 VALUE OPTIONS
New York Other 12362 VALUE OPTIONS
New York Other 182262 VALUE OPTIONS
New York Other 5861327 VALUE OPTIONS
New York Other N1432 VALUE OPTIONS

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