Susan Belitsky, LICSW

Individual provider Active NPI Social Worker · Providence, RI

NPI 1114970787 · NPPES record last updated Nov 7, 2007

Key facts

NPI
1114970787
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
ISW01590 (RI)
Practice address
580 Wickenden St
Providence, RI 02903-4400
Phone
(401) 621-1836
Fax
(401) 842-0360
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
ISW01590RIMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ISW01590 RI Yes

Addresses

Primary practice location

580 Wickenden St
Providence, RI 02903-4400

Mailing address

580 Wickenden St
Providence, RI 02903-4400
Phone (401) 621-1836

Other identifiers

IdentifierTypeStateIssuer
SB55217MedicaidRI

Other providers in Providence, RI

All providers in Providence, RI · Social Worker in Rhode Island

Sources for this page

Verify at the official NPI Registry.