Susan Fernandes Deoliveira, LCSW
Individual provider Active NPI Clinical Social Worker · North Haven, CT
NPI 1679736201 · NPPES record last updated Feb 8, 2017
Key facts
- NPI
- 1679736201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 009462 (CT)
- Practice address
- 352 State St
North Haven, CT 06473-3108 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009462 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apt Foundation, Inc | Past | Accepting new patients | |
| Apt Foundation Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 009462 | CT | Yes |
Addresses
Primary practice location
352 State St
North Haven, CT 06473-3108
Mailing address
1 Long Wharf Dr
Suite 321
New Haven, CT 06511-5991
Phone (203) 781-4600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004082286 | Medicaid | CT | |
| 008022626 | Medicaid | CT | |
| 008066551 | Other | CT | DEOLIVEIRA MEDICAID |
| 500000315 | Medicaid | CT |
Other providers in North Haven, CT
- Maura Demarco
- John Demayo
- Ralph Wayne Denatale
- Denson Counseling Services LLC
- Rodney Denson
- Tiffany Ann Deschamps
- Katherine Anne Destefano
- Jameel Besheer Dhanani
- Hailey Dias
- Vincent Dicola
All providers in North Haven, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.