Provider Demographics
NPI:1235312232
Name:HARPER, S. SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:S. SUSAN
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 W 86TH ST
Mailing Address - Street 2:SUITE E7
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2282
Mailing Address - Country:US
Mailing Address - Phone:317-255-1560
Mailing Address - Fax:
Practice Address - Street 1:1261 W 86TH ST
Practice Address - Street 2:SUITE E7
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2282
Practice Address - Country:US
Practice Address - Phone:317-255-1560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000978A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical