Provider Demographics
NPI:1891942462
Name:BRUSHART-SHAW, SUZANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BRUSHART-SHAW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-2124
Mailing Address - Country:US
Mailing Address - Phone:401-263-3945
Mailing Address - Fax:
Practice Address - Street 1:201 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-1864
Practice Address - Country:US
Practice Address - Phone:401-263-3945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health