Mr David Susanin, LCSW | |
500 Vine St, Hartford, CT 06112-1639 | |
(860) 297-0810 | |
(860) 293-6356 |
Full Name | Mr David Susanin |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 500 Vine St, Hartford, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013091719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 004901 (Connecticut) | Primary |
Entity Name | State Of Connecticut |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487689022 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000169 |
Mailing Address | Practice Location Address |
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Mr David Susanin, LCSW 424 Brimfield Rd, Wethersfield, CT 06109-3206 Ph: (860) 529-9113 | Mr David Susanin, LCSW 500 Vine St, Hartford, CT 06112-1639 Ph: (860) 297-0810 |
Mr. Glenn Gregory Gemma, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 555 Franklin Ave, Hartford, CT 06114 Phone: 860-756-8669 | |
Laurel Barrett, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 331 Wethersfield Ave, Hartford, CT 06114 Phone: 860-971-4761 | |
Isabella Pugliese, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 553 Farmington Ave, Hartford, CT 06105 Phone: 206-819-8258 | |
Maryellen Thomson Sciallo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1680 Albany Ave, Hartford, CT 06105 Phone: 860-236-4511 | |
Charlene Ann Snipes, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 500 Vine Street, Hartford, CT 06112 Phone: 860-297-0905 Fax: 860-297-0914 | |
Ms. Rebecca Jennifer Robotham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 65 Osten Blvd, Hartford, CT 06106 Phone: 860-729-2069 |