Basic Information
| Provider Information | |||||||||
| NPI: | 1194886911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHBY | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | SPITTAL | ||||||||
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| Credential: | LCSW | ||||||||
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| OtherLastName: | SPITTAL | ||||||||
| OtherFirstName: | SUSAN | ||||||||
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| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 227 THORN AVE | ||||||||
| Address2: | SPECTRUM HUMAN SERVICES | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141272600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166622040 | ||||||||
| FaxNumber: | 7166620019 | ||||||||
| Practice Location | |||||||||
| Address1: | 27 FRANKLIN ST | ||||||||
| Address2: | SPRINGVILLE COUNSELING CENTER | ||||||||
| City: | SPRINGVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141411314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165929301 | ||||||||
| FaxNumber: | 7165929376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 070250 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.