Provider Demographics
NPI:1437631033
Name:ARMENIA, SUSAN MAE (LICSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MAE
Last Name:ARMENIA
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 1:39 POINT ALLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-1448
Mailing Address - Country:US
Mailing Address - Phone:781-534-8014
Mailing Address - Fax:781-843-2405
Practice Address - Street 1:250 POND ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5351
Practice Address - Country:US
Practice Address - Phone:781-348-2041
Practice Address - Fax:781-843-2405
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker