Provider Demographics
NPI:1487958682
Name:KROLL, SUZANNE S (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:S
Last Name:KROLL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3612
Mailing Address - Country:US
Mailing Address - Phone:504-891-5807
Mailing Address - Fax:504-391-4341
Practice Address - Street 1:3519 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3612
Practice Address - Country:US
Practice Address - Phone:504-891-5807
Practice Address - Fax:504-391-4341
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1079104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker