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Provider Information for 1730639238


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Ms. SUS BELSCHNER AUSTILL LCSW


Sex: Female

NPI: 1730639238
Last Updated: 2016-10-07
Certification Date:

Details

NameValue
NPI1730639238
Enumeration Date2016-10-07
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1601 SW ARCHER RD
GAINESVILLE, FL 32608-1135
United States

Phone: 352-376-1611 | Fax:
 
Primary Practice Address 620 NW 16TH AVE
GAINESVILLE, FL 32601-4034
United States

Phone: 352-416-0566 | Fax:352-244-0811
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalFL11374