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General NPI Number Information
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NPI Number | 1952051385
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Entity Type | Individual
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Provider Name | SUSAN PRATT LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 14 WOODRUFF AVE STE 7
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City | NARRAGANSETT
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State | RI
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Zip | 02882-3467
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Country | US
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Telephone | 401-788-2310
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Fax | 401-788-8529
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Provider Business Mailing Address
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Address Line | PO BOX 229
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City | WAKEFIELD
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State | RI
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Zip | 02880-0229
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Country | US
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Telephone | 401-788-3929
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Fax | 401-788-3939
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW01132
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License Number State | RI
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