Provider Demographics
NPI:1922336569
Name:SEGAL, SUSAN G (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:G
Last Name:SEGAL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 P ST NW
Mailing Address - Street 2:#407
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5915
Mailing Address - Country:US
Mailing Address - Phone:202-463-7188
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW
Practice Address - Street 2:#407
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5915
Practice Address - Country:US
Practice Address - Phone:202-463-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3011011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical