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NPI Code Detail

MEDICARE: SUSAN ANDREW LICSW

MEDICARE: SUSAN ANDREW LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1032204MA

General Provider Information

NPI Number : 1225141773
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ANDREW LICSW
Provider Business Mailing Address
First Line : 135 HERITAGE WAY
Second Line :
City : HOLLISTON
State : MA
Zip : 01746
Country : US
Telephone Number : 508-429-5092
Fax Number :
Provider Business Practice Location Address
First Line : 20 MAIN ST
Second Line : SUITE 300
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 617-605-3071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 06/19/2026

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Directions to “ SUSAN ANDREW LICSW” Practice Location

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