Provider Demographics
NPI:1982354270
Name:SUSSEWELL, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:SUSSEWELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6043 N HIL MAR CIR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2962
Mailing Address - Country:US
Mailing Address - Phone:202-427-9166
Mailing Address - Fax:
Practice Address - Street 1:6043 N HIL MAR CIR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2962
Practice Address - Country:US
Practice Address - Phone:202-427-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician