1558413740 NPI number — SUSAN MORGANROTH DROBIS MSW LICSW

Table of content: SUSAN MORGANROTH DROBIS MSW LICSW (NPI 1558413740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558413740 NPI number — SUSAN MORGANROTH DROBIS MSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DROBIS
Provider First Name:
SUSAN
Provider Middle Name:
MORGANROTH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOGANROTH
Provider Other First Name:
SUSAN
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558413740
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4943 BRANDY WINE ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20016-4330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-244-0912
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4545 42ND ST NW
Provider Second Line Business Practice Location Address:
STE 304
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-4623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-686-9005
Provider Business Practice Location Address Fax Number:
202-363-1434
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LC300253 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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