Provider Demographics
NPI:1659963544
Name:LEICHTMAN, SUSAN TURRIFF (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:TURRIFF
Last Name:LEICHTMAN
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 1:29 WHITE PINE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON UPPER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1222
Mailing Address - Country:US
Mailing Address - Phone:617-512-3823
Mailing Address - Fax:
Practice Address - Street 1:29 WHITE PINE RD
Practice Address - Street 2:
Practice Address - City:NEWTON UPPER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02464-1222
Practice Address - Country:US
Practice Address - Phone:617-512-3823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10230021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical