Provider Demographics
NPI:1609015445
Name:SUSSMAN, RICHARD LEWIS (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LEWIS
Last Name:SUSSMAN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SASQUA TRL
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1025
Mailing Address - Country:US
Mailing Address - Phone:203-544-8418
Mailing Address - Fax:203-544-7168
Practice Address - Street 1:11 SASQUA TRL
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1025
Practice Address - Country:US
Practice Address - Phone:203-544-8418
Practice Address - Fax:203-544-7168
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01735711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical