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Individual
MRS. SUE FURTADO
Active
Individual
MRS. SUE FURTADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1219720
BEACON
MA
01
—
1730154741
BCBSRI
RI
05
—
1858912
—
MA
01
—
406420
MBH
MA
01
—
415137
TUFTS
MA
01
—
6248809
UBH
—
01
—
7C87510
AETNA
MA
01
—
81951
MEDICARE TIN
MA
01
—
P08101
BCBS
MA
Enumeration date
02/22/2006
Last updated
02/16/2015
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