Provider Demographics
NPI:1558646208
Name:HUNTER, SUSAN (LICSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HUNTER
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 1:888 BIRD BAY WAY
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-6110
Mailing Address - Country:US
Mailing Address - Phone:401-573-5378
Mailing Address - Fax:941-882-3537
Practice Address - Street 1:48 PECKHAM AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-1011
Practice Address - Country:US
Practice Address - Phone:401-573-5378
Practice Address - Fax:941-882-3537
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW024511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical