Provider Demographics
NPI:1639596489
Name:FUTTERMAN, SUSAN (LMFT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:FUTTERMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:SUSAN.
Other - Middle Name:
Other - Last Name:FUTTERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:509 SEACLIFF PL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-4132
Mailing Address - Country:US
Mailing Address - Phone:415-515-6253
Mailing Address - Fax:
Practice Address - Street 1:3120 TELEGRAPH AVE STE 11
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1965
Practice Address - Country:US
Practice Address - Phone:415-515-6253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist