Healthcare Provider Details

I. General information

NPI: 1649110057
Provider Name (Legal Business Name): SUSAN K THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 MAIN ST
WESTPORT CT
06880-3206
US

IV. Provider business mailing address

60 CRESCENT DR
MILFORD CT
06460-5030
US

V. Phone/Fax

Practice location:
  • Phone: 959-214-4738
  • Fax:
Mailing address:
  • Phone: 203-415-3450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUSAN KRUSHINSKY
Title or Position: OWNER
Credential: LPC
Phone: 959-214-4738