Provider Demographics
NPI:1609012558
Name:WEBB, SUSAN A (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:A
Last Name:WEBB
Suffix:
Gender:F
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 1:8901 IRON GATE CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4724
Mailing Address - Country:US
Mailing Address - Phone:240-463-1920
Mailing Address - Fax:
Practice Address - Street 1:10410 KENSINGTON PKWY STE 225
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2949
Practice Address - Country:US
Practice Address - Phone:240-463-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical