Fondry, Susan Williamson
Fondry, Susan Williamson is an sole proprietor health care provider with primary practice located at 600 E Unaka Ave , Johnson City TN 37601-4035. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fondry, Susan Williamson can be contacted via phone (423) 928-4003.Contact Information
Primary practice address
600 E Unaka Ave
Johnson City TN 37601-4035
Phone: (423) 928-4003
Fax: (423) 772-3689
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SWL3044 | Tennessee |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | COO2045 | North Carolina |
Profile Details
| NPI number | 1528276631 |
|---|---|
| LBN Legal business name | Fondry, Susan Williamson |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 21st, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528276631 | NPPES |
| North Carolina | MEDICAID | 6002879 |
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