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Individual

MRS. SUSAN LACEY WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, LICSW

Contact information

Practice address
466 MAIN STREET, SUITE 3, GREENFIELD, MA 01301
(413) 774-5012
(413) 339-0148
Mailing address
PO BOX 1002, CHARLEMONT, MA 01339-1002
(413) 774-5012
(413) 339-0148

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LICSW1023496
MA
163W00000X
Registered Nurse
144039
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32153
BMC HEALTHNET
MA
01
P08203
BCBS MA
MA
Enumeration date
06/20/2006
Last updated
10/19/2009
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