Provider Demographics
NPI:1386849073
Name:FERRADAS, SUSANA J (LMHC, PHD)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:J
Last Name:FERRADAS
Suffix:
Gender:F
Credentials:LMHC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SALEM ST # 7
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5290
Mailing Address - Country:US
Mailing Address - Phone:305-205-2898
Mailing Address - Fax:
Practice Address - Street 1:120 CURTIS ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-1243
Practice Address - Country:US
Practice Address - Phone:305-205-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7659101YM0800X
MD06238103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health