Provider Demographics
NPI:1881805281
Name:SCHWERD, SUSAN RACHEL (LCPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RACHEL
Last Name:SCHWERD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:RACHEL
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:121 MAPLE RD
Mailing Address - City:WASHINGTON GROVE
Mailing Address - State:MD
Mailing Address - Zip Code:20880-0127
Mailing Address - Country:US
Mailing Address - Phone:202-352-0264
Mailing Address - Fax:270-813-7197
Practice Address - Street 1:9037 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1301
Practice Address - Country:US
Practice Address - Phone:202-352-0264
Practice Address - Fax:646-365-1774
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017077100Medicaid