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Individual

MALCOLM ROSE SUSHCHYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW 00012367

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
123679
MA
1041C0700X
Clinical Social Worker
99467
CA
1041C0700X
Clinical Social Worker
Primary
ISW03525
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
99467
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
07/10/2014
Last updated
10/28/2025
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