Individual provider · NPI-1

Susan Diane Cavenaugh, LCSW

Social Worker, Clinical · Dublin, GA

NPI number1326164591
StatusActive
Last updated in NPPESMar 9, 2009

Details

NPI
1326164591
Entity type
Individual (NPI-1)
Name
Susan Diane Cavenaugh
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Mar 21, 2007
Last updated
Mar 9, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalCSW003332GAYes

Practice location

1826 Veteran'S Boulevard
Carl Vinson Va Medical Center
Dublin, GA 31021

Phone 478-272-1210 · Fax 478-277-2717

Mailing address

427 Preston Creek Dr
Mcdonough, GA 30253-8983

Phone 678-548-8813

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