National Provider Identifier
Susan Jane Petrillo, LCSW
Susan Jane Petrillo, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Warsaw, NY and a listed phone number of (585) 786-0190.
Profile Overview
- NPI
- 1013049998
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- March 09, 2007
- Last Updated
- July 08, 2007
Practice Location
- 39 Duncan St
- Warsaw, NY 14569-1017
Phone: (585) 786-0190
Mailing Address
- 17 Humphrey St
- Warsaw, NY 14569-9706
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1013049998
- Entity Type
- Individual
- Last Name
- Petrillo
- First Name
- Susan
- Middle Name
- Jane
- Name Prefix
- Mrs.
- Credential
- LCSW
- Mailing Street Address
- 17 Humphrey St
- Mailing City
- Warsaw
- Mailing State
- NY
- Mailing ZIP Code
- 14569-9706
- Mailing Country
- US
- Mailing Phone
- (585) 786-3665
- Practice Street Address
- 39 Duncan St
- Practice City
- Warsaw
- Practice State
- NY
- Practice ZIP Code
- 14569-1017
- Practice Country
- US
- Practice Phone
- (585) 786-0190
- Practice Fax
- (585) 786-0196
- Enumeration Date
- March 09, 2007
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)