Provider Demographics
NPI:1568879013
Name:WITTER, SUSAN ROBIN (MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ROBIN
Last Name:WITTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 CLOVER KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2380
Mailing Address - Country:US
Mailing Address - Phone:202-580-3512
Mailing Address - Fax:
Practice Address - Street 1:1120 G ST NW
Practice Address - Street 2:SUITE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3801
Practice Address - Country:US
Practice Address - Phone:202-628-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500795261041C0700X
MD161421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical