Provider Demographics
NPI:1437312345
Name:SHORR, SUSAN DENISE (LISW, PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DENISE
Last Name:SHORR
Suffix:
Gender:F
Credentials:LISW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4172 CROSSGATE LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1216
Mailing Address - Country:US
Mailing Address - Phone:513-891-7878
Mailing Address - Fax:
Practice Address - Street 1:4172 CROSSGATE LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1216
Practice Address - Country:US
Practice Address - Phone:513-891-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLISW-00007421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical