Provider Demographics
NPI:1437527421
Name:MATTHEWS, SUSANNAH KATE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSANNAH
Middle Name:KATE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 REDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3630
Mailing Address - Country:US
Mailing Address - Phone:617-288-7450
Mailing Address - Fax:617-232-7925
Practice Address - Street 1:77 VILCOM CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1789
Practice Address - Country:US
Practice Address - Phone:984-974-5217
Practice Address - Fax:984-974-9646
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0123351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical