MEDICARE: SUSAN M VOSBURGH 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	LC302011	DC
2	1041C0700X	Clinical Social Worker	05159	MD

General Provider Information

NPI Number	:	1841353810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN M VOSBURGH LCSW-C

Provider Business Mailing Address
First Line	:	3530 S RIVER TER
Second Line	:
City	:	EDGEWATER
State	:	MD
Zip	:	21037-3245
Country	:	US
Telephone Number	:	301-613-1741
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 OLD SOLOMONS ISLAND RD
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3825
Country	:	US
Telephone Number	:	410-266-9747
Fax Number	:	410-266-9749

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	04/24/2013

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