MEDICARE: SUSAN L BROUSSEAU LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC14487	ME

General Provider Information

NPI Number	:	1639467020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L BROUSSEAU LCSW

Provider Business Mailing Address
First Line	:	24 STONE ST STE 201
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-5209
Country	:	US
Telephone Number	:	207-213-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 STONE ST STE 201
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-5209
Country	:	US
Telephone Number	:	207-213-2161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	11/25/2019

Similar Medicare Providers

1225814817 — LAURYN MARIE BISSONNETTE LCPC
Practice Location Address:

24 STONE ST STE 201
AUGUSTA, ME
04330-5209

Practice Phone: 207-922-4600
Practice Fax: 207-623-3722

1154395580 — DR. BARBARA A. COX DO
Practice Location Address:

24 STONE ST STE 203
AUGUSTA, ME
04330-5209

Practice Phone: 207-623-8411
Practice Fax:

1407889108 — HANGER PROSTHETICS & ORTHOTICS, INC.
Practice Location Address:

24 STONE ST STE 105
AUGUSTA, ME
04330-5209

Practice Phone: 207-662-9792
Practice Fax: 207-622-4723

1376793257 — CVS STATE CAPITAL. L.L.C.
Practice Location Address:

24 STONE ST STE 120
AUGUSTA, ME
04330-5209

Practice Phone: 401-765-1500
Practice Fax:

1629384458 — LESLIE F LENNIG LCSW
Practice Location Address:

24 STONE ST STE 201
AUGUSTA, ME
04330-5209

Practice Phone: 207-213-2158
Practice Fax: 207-623-3722

1669771119 — MRS. ASHLEY ANNE JUAT MOT, OTR/L
Practice Location Address:

24 STONE ST STE 101
AUGUSTA, ME
04330-5209

Practice Phone: 207-582-8400
Practice Fax: 207-230-6701

Directions to “ SUSAN L BROUSSEAU LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.