Provider Demographics
NPI:1184194730
Name:CUNHA, SUSAN BARBARA (LICSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BARBARA
Last Name:CUNHA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 KING ST
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834
Mailing Address - Country:US
Mailing Address - Phone:978-373-2592
Mailing Address - Fax:
Practice Address - Street 1:151 KING ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:MA
Practice Address - Zip Code:01834
Practice Address - Country:US
Practice Address - Phone:978-373-2592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1153871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical