Susan T Johnson | Waltham, MA • PECOS Search

Susan T Johnson

Social Worker

Behavioral Health & Social Service Providers

61 Goldencrest Ave, Waltham, MA 02451-1318

PECOS Enrollment

Based on the most recent information from CMS, provider Susan T Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1952379331
Provider Type
Individual
Full Name
Johnson, Susan T
Title
Mrs.
Credential
MS LICSW BCD

Gender
Female
Sole Proprietor
No
Enumeration Date
3/10/2006
Last Updated
9/19/2011

Contact Information

Practice Location

61 Goldencrest Ave, Waltham, MA 02451-1318

(781) 290-0130

Mailing Location

61 Goldencrest Ave, Waltham, MA 02451-1318

(781) 290-0130

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 103125 Massachusetts