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Individual

SUSAN DEBORAH WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
3060 MITCHELLVILLE RD, SUITE 104, BOWIE, MD 20716-1389
(240) 475-2221
(301) 384-8876
Mailing address
12900 TOURMALINE TER, SILVER SPRING, MD 20904-5349
(301) 384-8876
(301) 249-8776

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC0769
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2178897
CIGNA EAP
MD
01
514031
VALUEOPTIONS
MD
01
562760
MAMSI/UNITED HEALTHCARE
MD
01
61672002
CAREFIRST MD RENDERING
MD
01
GQ40CO
BC/BS CAREFIRST MD
MD
01
M3280003
BC/BS CAREFIRST NATL CAP
MD
Enumeration date
05/17/2006
Last updated
07/08/2007
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