Shushansky, Larry M
Shushansky, Larry M is an sole proprietor health care provider with primary practice located at 182 Butler Ave Ste 4 , Providence RI 02906. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Shushansky, Larry M can be contacted via phone (401) 298-1209.Contact Information
Primary practice address
182 Butler Ave Ste 4
Providence RI 02906
Phone: (401) 298-1209
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ISW00391 | Rhode Island |
Profile Details
| NPI number | 1891747960 |
|---|---|
| LBN Legal business name | Shushansky, Larry M |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Jun 21st, 2018 - about 6 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 | 1891747960 | NPPES |
| Rhode Island | Other | 407868 | BLUE CHIP PROVIDER # |
| Rhode Island | Other | 30328-8 | BLUE CHIP PROVIDER # |
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