Provider Demographics
NPI:1407969066
Name:WHITCOMB, SUSAN NEEDY (MSW, LICS)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:NEEDY
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:MSW, LICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1212
Mailing Address - Street 2:
Mailing Address - City:WEST CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02669-1212
Mailing Address - Country:US
Mailing Address - Phone:508-945-0360
Mailing Address - Fax:508-945-1978
Practice Address - Street 1:572 ROUTE 28
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-4909
Practice Address - Country:US
Practice Address - Phone:508-775-0719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20268691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical