Provider Demographics
NPI:1780753616
Name:HOOD, SUSAN DEBRA (LICSW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:DEBRA
Last Name:HOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:DEBRA
Other - Last Name:GOUVEIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:E FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-0054
Mailing Address - Country:US
Mailing Address - Phone:508-527-6001
Mailing Address - Fax:
Practice Address - Street 1:23 PINECREST BEACH DR
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-4723
Practice Address - Country:US
Practice Address - Phone:508-527-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22065101YM0800X
MA1167191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health