Provider Demographics
NPI:1124395645
Name:RADCLIFFE, SUSAN CAMILLE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CAMILLE
Last Name:RADCLIFFE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CEDAR ST
Mailing Address - Street 2:DORCHESTER COUNTY HEALTH DEPARTMENT
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2362
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 CEDAR ST
Practice Address - Street 2:DORCHESTER COUNTY HEALTH DEPARTMENT
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2362
Practice Address - Country:US
Practice Address - Phone:410-228-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical