Provider Demographics
NPI:1194492082
Name:LIEMAN, SUSAN LEVIN (LCSW-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEVIN
Last Name:LIEMAN
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 1:17 BOXRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1269
Mailing Address - Country:US
Mailing Address - Phone:410-581-4988
Mailing Address - Fax:
Practice Address - Street 1:17 BOXRIDGE CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1269
Practice Address - Country:US
Practice Address - Phone:410-581-4988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD04286OtherSOCIAL WORKER