Provider Demographics
NPI:1699350082
Name:PERROTTI-SOUSIS, EDWARD (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:PERROTTI-SOUSIS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 FENN STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-3214
Mailing Address - Country:US
Mailing Address - Phone:413-499-0412
Mailing Address - Fax:
Practice Address - Street 1:75 CHURCH STREET
Practice Address - Street 2:FLOOR 6, SUITE 22
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:518-212-7295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090993-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical