National Provider Identifier
Susan M Willis, LCSW
Susan M Willis, LCSW is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (607) 274-6200.
Profile Overview
- NPI
- 1356389092
- Provider Type
- Individual
- Primary Specialty
- Social Worker
- Enumeration Date
- June 03, 2006
- Last Updated
- April 05, 2011
Practice Location
- 201 East Green St
- Ithaca, NY 14850
Phone: (607) 274-6200
Mailing Address
- 113 Texas Lane
- Ithaca, NY 14850
Specialties
- Social Worker (104100000X)
Full Record
- NPI
- 1356389092
- Entity Type
- Individual
- Last Name
- Willis
- First Name
- Susan
- Middle Name
- M
- Credential
- LCSW
- Mailing Street Address
- 113 Texas Lane
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850
- Mailing Country
- US
- Mailing Phone
- (607) 274-6200
- Mailing Fax
- (607) 274-6316
- Practice Street Address
- 201 East Green St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850
- Practice Country
- US
- Practice Phone
- (607) 274-6200
- Practice Fax
- (607) 274-6316
- Enumeration Date
- June 03, 2006
- Last Updated
- April 05, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Social Worker (104100000X)