Provider Demographics
NPI:1821467259
Name:MACALUSO, SUZANNE LYNNE (LICSW, LADC1, CCM)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:LYNNE
Last Name:MACALUSO
Suffix:
Gender:F
Credentials:LICSW, LADC1, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 STANIFORD ST FL 9
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2506
Mailing Address - Country:US
Mailing Address - Phone:617-724-6610
Mailing Address - Fax:
Practice Address - Street 1:VERTAVA HEALTH
Practice Address - Street 2:151 SOUTH STREET
Practice Address - City:CUMMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01026
Practice Address - Country:US
Practice Address - Phone:413-200-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1240961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical