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General NPI Number Information
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NPI Number | 1942253877
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Entity Type | Organization
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Legal Business Name | SUSAN A JOHNS LCSWC PA
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 405 FREDERICK RD SUITE 263
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City | BALTIMORE
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State | MD
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Zip | 21228-4647
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Country | US
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Telephone | 410-744-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 405 FREDERICK RD SUITE 263
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City | BALTIMORE
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State | MD
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Zip | 21228-4647
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Country | US
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Telephone | 410-744-2066
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Fax |
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Authorized Official
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Title or Position | DIRECTOR AND CLINICAL SOCIAL WORKER
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Name | SUSAN A JOHNS
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Credential | LCSW-C, MSW
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Telephone | 410-744-2066
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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 | 06934
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License Number State | MD
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