Gagnon, Susan Marie
Gagnon, Susan Marie is an sole proprietor health care provider with primary practice located at 937 South Main St Unit 4, Plantsville CT 06479-0413. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gagnon, Susan Marie can be contacted via phone (860) 384-9104.Contact Information
Primary practice address
937 South Main St Unit 4
Plantsville CT 06479-0413
Phone: (860) 384-9104
Fax: (860) 426-0596
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 002967 | Connecticut |
Profile Details
| NPI number | 1679608905 |
|---|---|
| LBN Legal business name | Gagnon, Susan Marie |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 23rd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679608905 | NPPES |
| Connecticut | Other | 002967 | LCSW LICENSE |
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