Individual
SUSAN D MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW MSW
Contact information
Practice address
420 FRUIT HILL AVE, NORTH PROVIDENCE, RI 02911-2647
(401) 783-3550
(401) 783-3550
Mailing address
420 FRUIT HILL AVE, NORTH PROVIDENCE, RI 02911-2647
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ISW01776
RI
101YM0800X
Mental Health Counselor
PR0168991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ISW01776
LICENSE
RI
01
—
PR016899-1
LICENSE
NY
Enumeration date
09/13/2006
Last updated
03/25/2008
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