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General NPI Number Information
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NPI Number | 1316132277
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Entity Type | Individual
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Provider Name | SUSAN D. LOFTIS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 1419 FOREST DR SUITE # 205
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1482
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Country | US
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Telephone | 443-254-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 44 TRIFECTA PL STE 205
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City | CHARLES TOWN
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State | WV
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Zip | 25414-5720
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Country | US
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Telephone | 304-728-3716
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Fax | 304-728-3740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05581
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License Number State | MD
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