Provider Demographics
NPI:1245745108
Name:LLUFRIO, SUSAN (CSC-AD, ADS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LLUFRIO
Suffix:
Gender:F
Credentials:CSC-AD, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W COURTLAND ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3701
Mailing Address - Country:US
Mailing Address - Phone:410-838-3442
Mailing Address - Fax:410-838-3341
Practice Address - Street 1:21 W COURTLAND ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3701
Practice Address - Country:US
Practice Address - Phone:410-838-3442
Practice Address - Fax:410-838-3341
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC0973101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)