Basic Information
| Provider Information | |||||||||
| NPI: | 1578770962 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARSTEN | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 N MACKINAW ST | ||||||||
| Address2: | |||||||||
| City: | DURAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484291315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894130159 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | G3375 S SAGINAW ST | ||||||||
| Address2: | |||||||||
| City: | BURTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485291277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107436830 | ||||||||
| FaxNumber: | 8107437086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 01/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801080914 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.