Provider Demographics
NPI:1235362377
Name:RICHMAN, SUSAN M (LCPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 DEL RAY AVE
Mailing Address - Street 2:SUITE 508
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2527
Mailing Address - Country:US
Mailing Address - Phone:301-654-1583
Mailing Address - Fax:
Practice Address - Street 1:4905 DEL RAY AVE
Practice Address - Street 2:SUITE 508
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2527
Practice Address - Country:US
Practice Address - Phone:301-654-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4506101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional