Hanks, Susan

Hanks, Susan is an individual health care provider with primary practice located at 3001 Warrior Ln , Poplar Bluff MO 63901-8685. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hanks, Susan can be contacted via phone (573) 686-1200.

Contact Information

Primary practice address
3001 Warrior Ln Poplar Bluff MO 63901-8685
Phone: (573) 686-1200
Fax: (573) 686-1029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2007027916 Missouri

Profile Details

NPI number 1497935258
LBN Legal business name Hanks, Susan
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2007
Last updated Oct 30th, 2023 - about 3 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 1497935258 NPPES
Other 11795658 CAQH
MEDICAID 494476104 CAQH

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