Provider Demographics
NPI:1821168097
Name:BUDZ, SUE (LICSW)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:BUDZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1077 N HOOSAC RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2312
Mailing Address - Country:US
Mailing Address - Phone:413-458-7974
Mailing Address - Fax:
Practice Address - Street 1:25 MARSHALL ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2451
Practice Address - Country:US
Practice Address - Phone:413-664-4541
Practice Address - Fax:413-662-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10260601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31753OtherHEALTH NEW ENGLAND
MA31753OtherHEALTH NEW ENGLAND