Provider Demographics
NPI:1558403055
Name:SMOLKIN, SUZANNE (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SMOLKIN
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3788 ANGELTON CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2060
Mailing Address - Country:US
Mailing Address - Phone:301-890-3319
Mailing Address - Fax:
Practice Address - Street 1:8607 2ND AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3355
Practice Address - Country:US
Practice Address - Phone:301-509-5936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114621041C0700X
DCLC30007751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical