Provider Demographics
NPI:1235391731
Name:HADDAD, SUZANNE KERIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:KERIN
Last Name:HADDAD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 COLUMBIA RD NW
Mailing Address - Street 2:STE 101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2031
Mailing Address - Country:US
Mailing Address - Phone:202-297-8162
Mailing Address - Fax:202-280-6677
Practice Address - Street 1:1801 COLUMBIA RD NW
Practice Address - Street 2:STE 101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2031
Practice Address - Country:US
Practice Address - Phone:202-297-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical