Provider Demographics
NPI:1154565786
Name:COALE, SUSAN MERCER (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MERCER
Last Name:COALE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 DEFENSE HWY
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8955
Mailing Address - Country:US
Mailing Address - Phone:410-987-2129
Mailing Address - Fax:443-837-1539
Practice Address - Street 1:445 DEFENSE HWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-8955
Practice Address - Country:US
Practice Address - Phone:410-987-2129
Practice Address - Fax:443-837-1539
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD048861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical