Healthcare Provider Details

I. General information

NPI: 1457463846
Provider Name (Legal Business Name): SUSAN H FISHBEIN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 DUNKIRK RD
BALTIMORE MD
21212-2015
US

IV. Provider business mailing address

604 DUNKIRK RD
BALTIMORE MD
21212-2015
US

V. Phone/Fax

Practice location:
  • Phone: 410-521-2150
  • Fax: 410-377-2162
Mailing address:
  • Phone: 410-521-2150
  • Fax: 410-377-2162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number01936
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01936
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number01936
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: