Individual
SUSANNA M PHILIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW, LCDP
Contact information
Practice address
EAST BAY MENTAL HEALTH CENTER, 2 OLD COUNTY ROAD, BARRINGTON, RI 02806
(401) 246-1195
Mailing address
2 OLD COUNTY RD, BARRINGTON, RI 02806-1602
(401) 246-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDP00050
RI
104100000X
Social Worker
1SW01479
RI
1041C0700X
Clinical Social Worker
Primary
ISW01479
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264772
BLUE CROSS
—
01
—
41006
BLUE CHIP
—
01
—
62-47775
UBH
—
Enumeration date
08/10/2006
Last updated
04/28/2008
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