Susan Marie Harrison, RADT-I

Individual provider Active NPI Case Manager/Care Coordinator · Taft, CA

NPI 1669718193 · NPPES record last updated Dec 9, 2019

Key facts

NPI
1669718193
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1021 4TH St # B
Taft, CA 93268-2433
Phone
(661) 765-7025
Fax
(661) 765-7045
NPI assigned
Jan 3, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R1192480215CAMDAddiction (Substance Use Disorder) Counselor
RIH1309110010CAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1192480215 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X RIH1309110010 CA
Mental Health Counselor 101YM0800X CA
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1021 4TH St # B
Taft, CA 93268-2433

Mailing address

1021 4TH St # B
Taft, CA 93268-2433
Phone (661) 765-7025

Other practice location 1

2901 S H St
Bakersfield, CA 93304-5602
Phone (661) 398-4303 ext. 20721

Other identifiers

IdentifierTypeStateIssuer
SUZANH06OtherCAMENTAL HEALTH SERVICES COUNSELOR
SUZANH06MedicaidCA
1669718193OtherCASUBSTANCE ABUSE COUNSELOR

Electronic endpoints

TypeEndpointUseAffiliation
Other URL 911 Direct

Other providers in Taft, CA

All providers in Taft, CA · Case Manager/Care Coordinator in California

Sources for this page

Verify at the official NPI Registry.