Provider Demographics
NPI:1003609363
Name:ROSENTHAL SCHUTT, SUSANNAH V (RDT, MCH-A)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:V
Last Name:ROSENTHAL SCHUTT
Suffix:
Gender:F
Credentials:RDT, MCH-A
Other - Prefix:
Other - First Name:SUSIE
Other - Middle Name:
Other - Last Name:SCHUTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2756 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2756 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3077
Practice Address - Country:US
Practice Address - Phone:401-379-1103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI833101200000X
RIMHC00087-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist