Provider Demographics
NPI:1780745984
Name:SFERRA, SUSAN P (MS LCMFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:P
Last Name:SFERRA
Suffix:
Gender:F
Credentials:MS LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 N PRINCE FREDERICK BLVD.
Mailing Address - Street 2:SUITE 222
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678
Mailing Address - Country:US
Mailing Address - Phone:410-474-7557
Mailing Address - Fax:
Practice Address - Street 1:995 N PRINCE FREDERICK BLVD.
Practice Address - Street 2:SUITE 222
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678
Practice Address - Country:US
Practice Address - Phone:410-474-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist