Provider Demographics
NPI:1649542242
Name:FREEDMAN, SUZANNE RACHEL (LCSW-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:RACHEL
Last Name:FREEDMAN
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 1:12076 LONG LAKE DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1250
Mailing Address - Country:US
Mailing Address - Phone:410-654-8758
Mailing Address - Fax:
Practice Address - Street 1:3525 RESOURCE DR
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4733
Practice Address - Country:US
Practice Address - Phone:410-922-1900
Practice Address - Fax:410-922-6288
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD152441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15244OtherSTATE LICENSE