Provider Demographics
NPI:1376654194
Name:PELZ, SUZANNE JANIS (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:JANIS
Last Name:PELZ
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:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636
Mailing Address - Country:US
Mailing Address - Phone:301-373-3065
Mailing Address - Fax:301-373-6143
Practice Address - Street 1:44101 AIRPORT VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636
Practice Address - Country:US
Practice Address - Phone:301-373-3065
Practice Address - Fax:301-373-6143
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health