Provider Demographics
NPI:1174631584
Name:DIAMOND, SUSAN B (LICSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 515
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-3603
Mailing Address - Country:US
Mailing Address - Phone:202-333-3100
Mailing Address - Fax:
Practice Address - Street 1:1010 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 515
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3603
Practice Address - Country:US
Practice Address - Phone:202-333-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC302351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health