Provider Demographics
NPI:1053996769
Name:HEBERT, SUE ANNE (MSW LISW-S)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:ANNE
Last Name:HEBERT
Suffix:
Gender:F
Credentials:MSW LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6797 N HIGH ST STE 223
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2533
Mailing Address - Country:US
Mailing Address - Phone:614-330-7828
Mailing Address - Fax:
Practice Address - Street 1:6797 N HIGH ST STE 223
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2533
Practice Address - Country:US
Practice Address - Phone:614-330-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI94981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical