MEDICARE: SUZANNE SMOLKIN MSW, LCSW-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	11462	MD
2	1041C0700X	Clinical Social Worker	LC3000775	DC

General Provider Information

NPI Number	:	1558403055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE SMOLKIN MSW, LCSW-C

Provider Business Mailing Address
First Line	:	3788 ANGELTON CT
Second Line	:
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-2060
Country	:	US
Telephone Number	:	301-890-3319
Fax Number	:

Provider Business Practice Location Address
First Line	:	8607 2ND AVE
Second Line	:	SUITE 503
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3355
Country	:	US
Telephone Number	:	301-509-5936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/08/2007

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