1881805281 NPI number — SUSAN RACHEL SCHWERD LCPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881805281 NPI number — SUSAN RACHEL SCHWERD LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWERD
Provider First Name:
SUSAN
Provider Middle Name:
RACHEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'BRIEN
Provider Other First Name:
SUSAN
Provider Other Middle Name:
RACHEL
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:
1881805281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 127
Provider Second Line Business Mailing Address:
121 MAPLE RD
Provider Business Mailing Address City Name:
WASHINGTON GROVE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20880-0127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-352-0264
Provider Business Mailing Address Fax Number:
270-813-7197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9037 SHADY GROVE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAITHERSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20877-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-352-0264
Provider Business Practice Location Address Fax Number:
646-365-1774
Provider Enumeration Date:
05/25/2007

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: 101YP2500X , with the licence number:  2134 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 017077100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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