Provider Demographics
NPI:1821517442
Name:DEWITT, SUZAN
Entity type:Individual
Prefix:
First Name:SUZAN
Middle Name:
Last Name:DEWITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:NH
Mailing Address - Zip Code:03592-5219
Mailing Address - Country:US
Mailing Address - Phone:603-331-3604
Mailing Address - Fax:307-323-3953
Practice Address - Street 1:6 FIRST ST
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3128
Practice Address - Country:US
Practice Address - Phone:603-331-3604
Practice Address - Fax:307-323-3953
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1217101YA0400X
101YM0800X
NH24221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health