Montaquilla, Susan

Montaquilla, Susan is an individual health care provider with primary practice located at 111 Howard Ave Bldg 56 , Cranston RI 02920-3001. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Montaquilla, Susan can be contacted via phone (401) 462-1021.

Contact Information

Primary practice address
111 Howard Ave Bldg 56 Cranston RI 02920-3001
Phone: (401) 462-1021
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MHC00329 Rhode Island
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDP00239 Rhode Island

Profile Details

NPI number 1366483125
LBN Legal business name Montaquilla, Susan
Credentials LMHC, LCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Mar 30th, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366483125 NPPES
Rhode Island Other 414072 BLUE CHIP
Rhode Island Other 32427-4 BLUE CHIP
Rhode Island Other 62-42464 BLUE CHIP
Rhode Island MEDICAID SM55220 BLUE CHIP
Rhode Island Other 1104847946 BLUE CHIP

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