Provider Demographics
NPI:1598177594
Name:TAYLOR, SUSAN ASHLEY (CMA, MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ASHLEY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CMA, 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 1:22H HILLSIDE RD UNIT H
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1746
Mailing Address - Country:US
Mailing Address - Phone:443-540-2875
Mailing Address - Fax:
Practice Address - Street 1:9111 EDMONSTON RD STE 303
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1552
Practice Address - Country:US
Practice Address - Phone:443-540-2875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-24
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MD169661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical