Provider Demographics
NPI:1902194731
Name:GAUDET, SUSAN E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:GAUDET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:FARRINGTON
Other - Last Name:MAREAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:84 GORDON FARMS RD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2389
Mailing Address - Country:US
Mailing Address - Phone:207-613-6843
Mailing Address - Fax:207-419-2732
Practice Address - Street 1:84 GORDON FARMS RD
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2389
Practice Address - Country:US
Practice Address - Phone:207-613-6843
Practice Address - Fax:207-419-2732
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC141051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical