Healthcare Provider Details

I. General information

NPI: 1649203340
Provider Name (Legal Business Name): SUSAN SAAZ BARSKY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN S BARSKY

II. Dates (important events)

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

III. Provider practice location address

268 PRINCE STREET
WEST NEWTON MA
02465
US

IV. Provider business mailing address

PO BOX 700
AYER MA
01432-0700
US

V. Phone/Fax

Practice location:
  • Phone: 617-965-1338
  • Fax:
Mailing address:
  • Phone: 978-772-7895
  • Fax: 978-772-4176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number102419
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: