Healthcare Provider Details

I. General information

NPI: 1538201355
Provider Name (Legal Business Name): SUSAN LEE TOHN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

296 W SLEEPY HOLLOW RD
ESSEX JUNCTION VT
05452-2747
US

V. Phone/Fax

Practice location:
  • Phone: 978-790-6131
  • Fax:
Mailing address:
  • Phone: 978-790-6131
  • Fax: 978-790-6131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1019532
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: