Healthcare Provider Details

I. General information

NPI: 1235202383
Provider Name (Legal Business Name): SUSAN DUMONT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N FRONT ST
NEW BEDFORD MA
02740-7350
US

IV. Provider business mailing address

310 BAKERVILLE RD
SOUTH DARTMOUTH MA
02748-1116
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-0475
  • Fax: 508-997-0765
Mailing address:
  • Phone: 508-997-5994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5443
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: