Provider Demographics
NPI:1134238256
Name:MORRISON, SUSAN KNOWLES (LCSW-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KNOWLES
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:SUSAN
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2214 SULGRAVE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4404
Mailing Address - Country:US
Mailing Address - Phone:410-542-0935
Mailing Address - Fax:
Practice Address - Street 1:6 PARK CENTER CT
Practice Address - Street 2:103
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5601
Practice Address - Country:US
Practice Address - Phone:410-356-3344
Practice Address - Fax:410-356-4459
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD084211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD614M993FMedicare ID - Type Unspecified