Provider Demographics
NPI:1366581431
Name:MAJESKI, SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MAJESKI
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 1:306 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:RITZVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99169-1620
Mailing Address - Country:US
Mailing Address - Phone:208-610-6401
Mailing Address - Fax:509-659-0556
Practice Address - Street 1:301 N 1ST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1456
Practice Address - Country:US
Practice Address - Phone:208-610-6401
Practice Address - Fax:509-659-0556
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW 26922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDL5691OtherBLUE CROSS OF IDAHO
ID000010153183OtherREGENCE BLUE SHIELD