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Individual
SUSAN FERTIG
Active
Individual
SUSAN FERTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
20061
MD
1041C0700X
Clinical Social Worker
0904013618
VA
1041C0700X
Clinical Social Worker
19242
SC
1041C0700X
Clinical Social Worker
Primary
20061
MD
Other
Enumeration date
12/16/2016
Last updated
09/16/2026
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