Provider Demographics
NPI:1942305172
Name:HUTCHINSON, SUSAN MARIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 CAPE DR
Mailing Address - Street 2:UNIT 11A
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3057
Mailing Address - Country:US
Mailing Address - Phone:508-539-3284
Mailing Address - Fax:
Practice Address - Street 1:195 FALMOUTH RD
Practice Address - Street 2:APT 6D
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2683
Practice Address - Country:US
Practice Address - Phone:617-847-1950
Practice Address - Fax:617-774-1490
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10289661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP20885Medicare ID - Type Unspecified