Provider Demographics
NPI:1790829315
Name:BARCELOS, SUSAN JEANNE (MA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JEANNE
Last Name:BARCELOS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:JEANNE
Other - Last Name:MENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 TITUS ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6128
Mailing Address - Country:US
Mailing Address - Phone:508-672-1912
Mailing Address - Fax:
Practice Address - Street 1:558 PLEASANT ST
Practice Address - Street 2:SUITE 207
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6246
Practice Address - Country:US
Practice Address - Phone:508-990-0418
Practice Address - Fax:508-979-4580
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health