Mccammon, Susan J

Mccammon, Susan J is an individual health care provider with primary practice located at 1811 Weir Dr Ste 270 , Woodbury MN 55125-6741. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mccammon, Susan J can be contacted via phone (651) 714-9646.

Contact Information

Primary practice address
1811 Weir Dr Ste 270 Woodbury MN 55125-6741
Fax: (651) 714-9647
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7573 Minnesota

Profile Details

NPI number 1699728816
LBN Legal business name Mccammon, Susan J
Credentials LICSW, MA
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Sep 24th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699728816 NPPES
Minnesota MEDICAID 867857000
Minnesota Other 5886611
Minnesota Other 62-60241
Minnesota Other 01013342
Minnesota Other 127605
Minnesota Other 855661013342
Minnesota Other 61Q70SI

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