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General NPI Number Information
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NPI Number | 1992784276
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Entity Type | Individual
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Provider Name | SUZANNE M KRESIAK LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 25 HENRY AVE
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City | PITTSFIELD
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State | MA
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Zip | 01201-6722
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Country | US
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Telephone | 413-358-3551
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Fax | 413-961-5455
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Provider Business Mailing Address
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Address Line | 1872 N STREAMLINE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4434
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Country | US
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Telephone | 413-358-3551
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Fax | 413-961-5455
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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 | 110156
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License Number State | MA
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