Provider Demographics
NPI:1639371768
Name:HARTNETT, SUSAN LYNNE (MSW LCSW ACSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LYNNE
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:MSW LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 POST RD # B
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-7573
Mailing Address - Country:US
Mailing Address - Phone:401-789-3059
Mailing Address - Fax:
Practice Address - Street 1:2905 POST RD
Practice Address - Street 2:SUITE 7 KRAEMER BLDG
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3176
Practice Address - Country:US
Practice Address - Phone:401-595-6170
Practice Address - Fax:401-789-3059
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0585641041S0200X
RICSW01156101YM0800X
RI436101YM0800X
RIISW019821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health