Susan Waverly Gagnon in Pittsfield - Clinical
Susan Waverly Gagnon - NPI 1376553669
Susan Waverly Gagnon is a Clinical in Pittsfield, Massachusetts. Susan Waverly Gagnon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Susan Waverly Gagnon is 1376553669. The last update date is 2007-07-08.
Susan Waverly Gagnon's current location address is 725 North Street, Pittsfield, Massachusetts. You can contact this provider via phone number 4134472655 and fax number 4134472656. The mailing address for Susan Waverly Gagnon is 725 North Street, Pittsfield, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Waverly Gagnon |
|---|---|
| Address | 725 North Street, Pittsfield, Massachusetts |
| Phone Number | 4134472655 |
| Fax Number | 4134472656 |
| Sole Proprietor | N |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1376553669 |
|---|---|
| Provider Enumeration Date | 2006-08-09 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 725 North Street |
|---|---|
| City | Pittsfield |
| State | Massachusetts (MA) |
| Post Code | 12018501 |
| Phone Number | 4134472655 |
| Fax Number | 4134472656 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 105461 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1200143 | MA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Susan Waverly Gagnon?
The Susan Waverly Gagnon has been issued the NPI (National Provider Identifier) 1376553669 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Susan Waverly Gagnon's physical address?
The Susan Waverly Gagnon is physically located at 725 North Street, in the city of Pittsfield, MA, with the postal code 12018501.
What is the area of specialization for Susan Waverly Gagnon, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Susan Waverly Gagnon is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1376553669 to Susan Waverly Gagnon?
The Centers for Medicare & Medicaid Services originally issued the 1376553669 to Susan Waverly Gagnon on 2006-08-09.
As of what date were the Susan Waverly Gagnon's details last updated?
The information pertaining to the Susan Waverly Gagnon, including its address, specialty, and other details, was most recently updated on 2007-07-08.