Provider Demographics
NPI:1821378498
Name:SUSSMAN, GABRIEL PERRY (LGPC)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:PERRY
Last Name:SUSSMAN
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N PARKE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2428
Mailing Address - Country:US
Mailing Address - Phone:443-625-1600
Mailing Address - Fax:443-625-1520
Practice Address - Street 1:135 N PARKE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2428
Practice Address - Country:US
Practice Address - Phone:443-625-1600
Practice Address - Fax:443-625-1520
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor