Provider Demographics
NPI:1003330374
Name:CONKLING, SUZANNE ADELMAN (LICSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ADELMAN
Last Name:CONKLING
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:LEIGH
Other - Last Name:ADELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1819 1ST ST NW # A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1819 1ST ST NW # A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1069
Practice Address - Country:US
Practice Address - Phone:914-263-1094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500826361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical