Provider Demographics
NPI:1417178500
Name:REDFIELD, SUSAN CYDELL (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CYDELL
Last Name:REDFIELD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CYD
Other - Middle Name:
Other - Last Name:REDFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:90 OAK ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1908
Mailing Address - Country:US
Mailing Address - Phone:401-331-3271
Mailing Address - Fax:
Practice Address - Street 1:5 BANK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2312
Practice Address - Country:US
Practice Address - Phone:508-222-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health