Doctor Name: | MS. LARAINE SHORE-SUSLOWITZ |
NPI Number: | 1033278320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW,MSW |
License Number: | 105630 |
Business Practice Address: | 108 Woodside Dr Longmeadow, MA - 011062042 |
Business Phone Number: | 4135371957 |
Business Fax Number: | 4135679993 |
Mailing Address: | 108 Woodside Dr, LONGMEADOW |
State: | MA |
Postal Code: | 011062042 |
Phone Number: | 4135371957 |
Fax Number: | 4135679993 |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 08/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 105630 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |