Susan Mandrachia Killebrew, MSW
Social Worker, Clinical in Portsmouth, RI. Individual provider (NPI-1).
NPI number1760660773
StatusActive
Last updated in NPPESNov 25, 2008
Details
- NPI
- 1760660773
- Entity type
- Individual (NPI-1)
- Name
- Susan Mandrachia Killebrew
- Credential
- MSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 1, 2008
- Last updated
- Nov 25, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | ISW00095 | RI | Yes |
Practice location
107 Clock Tower SquarePortsmouth, RI 02871
Phone 401-683-7600 · Fax 401-683-5415
Mailing address
15 Clarke St#1
Newport, RI 02840-3047
Phone 401-847-4115 · Fax 401-847-8737
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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