Individual
SUSAN VAN LEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1255 OAKLAWN AVE, SUITE # 2, CRANSTON, RI 02920-2649
(401) 228-7914
Mailing address
1255 OAKLAWN AVE, SUITE # 2, CRANSTON, RI 02920-2649
(401) 228-7914
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW00522
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30885-4
BLUE CROSS
RI
01
—
406424
BLUE CHIP
RI
01
—
62-15766
UNITED BEHAVIORAL HEALTH
RI
05
—
SG12457
—
RI
Enumeration date
06/02/2006
Last updated
03/29/2010
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