Individual
MS. SUSAN ANN TANGIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC LCADC
Contact information
Practice address
800 INGLESIDE AVE, CATONSVILLE, MD 21228-1722
(410) 744-5937
(410) 744-9423
Mailing address
3134 CHATHAM CT, ELLICOTT CITY, MD 21042-2410
(410) 465-8448
(410) 744-9423
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA343
MD
101YP2500X
Professional Counselor
Primary
LC1260
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089
BS FEDERAL GROUP S003
—
01
—
100072697
APS
—
01
—
11554503
CAQH
—
01
—
2124028
MAMSI UNITED HEALTH CARE
—
01
—
328196
MHN AND TRICARE
—
05
—
333404000
—
MD
01
—
487506
VALUE OPTIONS GREAT WEST
—
01
—
522229157
PHCS
—
01
—
63662901
BLUE SHIELD
MD
01
—
721298000
MAGELLAN BEHAVIORAL HEALT
—
01
—
7284589
AETNA BEHAVIORAL HEALTH
—
Enumeration date
04/05/2006
Last updated
11/14/2016
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