Provider Demographics
NPI:1841648441
Name:ASHTIANIE, SUSAN MICHEL (LCPC, NCC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MICHEL
Last Name:ASHTIANIE
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4926
Mailing Address - Country:US
Mailing Address - Phone:410-719-0086
Mailing Address - Fax:
Practice Address - Street 1:1 N BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4926
Practice Address - Country:US
Practice Address - Phone:410-719-0086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MDLC11315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional