Provider Demographics
NPI:1568670636
Name:BERMAN, SUSAN ELIZABETH (L AC, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:BERMAN
Suffix:
Gender:F
Credentials:L AC, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13808 IVYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5470
Mailing Address - Country:US
Mailing Address - Phone:301-384-1401
Mailing Address - Fax:
Practice Address - Street 1:10723 COLUMBIA PIKE STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4445
Practice Address - Country:US
Practice Address - Phone:301-754-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU001008171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist