Susan Mary Gubilee, MS, MSW

Individual provider Active NPI Clinical Social Worker · Portland, CT

NPI 1861667776 · NPPES record last updated Apr 23, 2008

Key facts

NPI
1861667776
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
11 Russell Ave
Portland, CT 06480-1433
Phone
(860) 342-4079
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

11 Russell Ave
Portland, CT 06480-1433

Mailing address

11 Russell Ave
Portland, CT 06480-1433
Phone (860) 342-4079

Other providers in Portland, CT

All providers in Portland, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.