Healthcare Provider Details

I. General information

NPI: 1235275025
Provider Name (Legal Business Name): SUSAN D BERLIN MSW, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 03/01/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1054 31ST ST NW SUITE 500
WASHINGTON DC
20007
US

IV. Provider business mailing address

5185 MACARTHUR BLVD NW SUITE 103 #587
WASHINGTON DC
20016-3341
US

V. Phone/Fax

Practice location:
  • Phone: 202-333-1787
  • Fax:
Mailing address:
  • Phone: 202-333-1787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6587
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR046839-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-1262
License Number StateWY
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC303286
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11513
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012053
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: