Provider Demographics
NPI:1841353810
Name:VOSBURGH, SUSAN M (LCSW-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:VOSBURGH
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 1:3530 S RIVER TER
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-3245
Mailing Address - Country:US
Mailing Address - Phone:301-613-1741
Mailing Address - Fax:
Practice Address - Street 1:133 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3825
Practice Address - Country:US
Practice Address - Phone:410-266-9747
Practice Address - Fax:410-266-9749
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3020111041C0700X
MD051591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical