Individual
SUSAN MASCOOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
232 BLUE HILL AVE, MILTON, MA 02186-1155
(617) 696-7236
(617) 323-7301
Mailing address
232 BLUE HILL AVE, MILTON, MA 02186-1155
(617) 696-7236
(617) 323-7301
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
6875
MA
103T00000X
Psychologist
6875
MA
103TC0700X
Clinical Psychologist
Primary
6875
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0503339
—
MA
01
—
W50009
BLUE CROSS
MA
Enumeration date
01/08/2007
Last updated
09/11/2025
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