Provider Demographics
NPI:1679533996
Name:ZUCKERMAN-MORELL, SUSAN (LC SW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:ZUCKERMAN-MORELL
Suffix:
Gender:F
Credentials:LC SW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ZUCKERMAN
Other - Last Name:MORELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:469 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4301
Mailing Address - Country:US
Mailing Address - Phone:718-832-4665
Mailing Address - Fax:718-369-8901
Practice Address - Street 1:469 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4301
Practice Address - Country:US
Practice Address - Phone:718-832-4665
Practice Address - Fax:718-369-8901
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR020307-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical