Provider Demographics
NPI:1255476586
Name:LESCHT, SUZANNE LEVY (LCSW C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LEVY
Last Name:LESCHT
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 1:3647 GROSVENOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-461-1903
Mailing Address - Fax:
Practice Address - Street 1:10632 LITTLE PATUXENT PKWY
Practice Address - Street 2:STE 245
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3273
Practice Address - Country:US
Practice Address - Phone:410-997-1919
Practice Address - Fax:410-997-1993
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10317104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PVPB124752OtherAMERICAN PSYCH SYSTEMS
MD281637OtherMAMSI OPTIMUM CHOICE
MDH1240004OtherCAREFIRST BCBS
143680OtherVALUE OPTIONS
226998OtherMANAGED HEALTH NETWORK
MD76938703OtherCAREFIRST BCBS
254418000OtherMAGELLAN BEHAVIORAL HLTH
486958800OtherFECA
9099704OtherPRIVATE HEALTHCARE SYSTEM
MD281637OtherMD IPA ALLIANCE
9099704OtherPRIVATE HEALTHCARE SYSTEM