=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770795700
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | C. SUZANNE BIERER LCSW-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3355 SAINT JOHNS LN STE F
-----------------------------------------------------
City | ELLICOTT CITY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21042-2600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-312-9930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5717 HARPERS FARM RD UNIT C
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21044-2297
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-992-5431
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 08249
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------