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General NPI Number Information
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NPI Number | 1013760503
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Entity Type | Organization
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Legal Business Name | SUSAN KNADE LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 121 N WEST ST STE A
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City | EASTON
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State | MD
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Zip | 21601-2709
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Country | US
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Telephone | 410-310-6215
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Fax |
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Provider Business Mailing Address
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Address Line | 4767 SAILORS RETREAT RD
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City | OXFORD
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State | MD
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Zip | 21654-1740
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Country | US
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Telephone | 410-310-6215
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN KNADE
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Credential | LCSW-C
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Telephone | 410-310-6215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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