Provider Demographics
NPI:1629540745
Name:TEMPLETON, SUZANNE FISCH (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:FISCH
Last Name:TEMPLETON
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 1:2903 DUNLEER RD
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-5113
Mailing Address - Country:US
Mailing Address - Phone:410-282-9430
Mailing Address - Fax:667-600-4093
Practice Address - Street 1:2903 DUNLEER RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-5113
Practice Address - Country:US
Practice Address - Phone:410-282-9430
Practice Address - Fax:667-600-4093
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD113671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical