Provider Demographics
NPI:1548392111
Name:GUSCHWAN, GEORGE M (LCSW-C)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:GUSCHWAN
Suffix:
Gender:M
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 1:4201 TUCKERMAN ST
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2144
Mailing Address - Country:US
Mailing Address - Phone:301-502-8245
Mailing Address - Fax:301-927-4340
Practice Address - Street 1:9475 LOTTSFORD RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5357
Practice Address - Country:US
Practice Address - Phone:301-636-6504
Practice Address - Fax:301-636-6509
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD155471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical