Provider Demographics
NPI:1912201542
Name:RAMONDETTA, SUSAN MARGARET (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARGARET
Last Name:RAMONDETTA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4884
Mailing Address - Country:US
Mailing Address - Phone:508-732-3000
Mailing Address - Fax:
Practice Address - Street 1:1029 PLEASANT ST STE 101
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2473
Practice Address - Country:US
Practice Address - Phone:508-697-1070
Practice Address - Fax:508-697-1020
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical