Deoliveira, Susan Fernandes

Deoliveira, Susan Fernandes is an individual health care provider with primary practice located at 352 State St , North Haven CT 06473-3108. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Deoliveira, Susan Fernandes can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
352 State St North Haven CT 06473-3108
Phone: (203) 781-4600
Fax: (203) 781-4624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 009462 Connecticut

Profile Details

NPI number 1679736201
LBN Legal business name Deoliveira, Susan Fernandes
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2008
Last updated Feb 8th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679736201 NPPES
Connecticut MEDICAID 004082286
Connecticut MEDICAID 008022626
Connecticut Other 008066551
Connecticut MEDICAID 500000315

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