Provider Demographics
NPI:1104399831
Name:SCHUMACHER, SUSAN ELISABETH (PHD (ABD), LPC, LCPC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:ELISABETH
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:PHD (ABD), LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20714-9617
Mailing Address - Country:US
Mailing Address - Phone:610-745-0973
Mailing Address - Fax:
Practice Address - Street 1:1064 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEACH
Practice Address - State:MD
Practice Address - Zip Code:20714-9617
Practice Address - Country:US
Practice Address - Phone:610-745-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9225101YP2500X
PAPC007222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty