Provider Demographics
NPI:1457340218
Name:SOSIN, DEBRA SUE (LICSW MSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:SUE
Last Name:SOSIN
Suffix:
Gender:F
Credentials:LICSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3923
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-594-9649
Practice Address - Street 1:15 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3923
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-594-9649
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y000729NH01OtherBCBS