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MS. SUSAN ANN TANGIRES LCPC LCADC

Addiction Substance Use Disorder

Catonsville, Maryland

Provider NPI: 1033171061

Provider Information:
MS. SUSAN ANN TANGIRES LCPC LCADC
Gender: F
Not Sole Proprietor

Practice Location:
800 INGLESIDE AVE  CATONSVILLE, MD 21228 US
Tel: 410-744-5937  Fax: 410-744-9423

Business Mailing Address:
3134 CHATHAM CT  ELLICOTT CITY, MD 21042 US
Tel: 410-465-8448  Fax: 410-744-9423

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MDLCA343
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
MDLC1260

Other Provider Identifiers:

IssuerNumberStateType
BS FEDERAL GROUP S003008901
PHCS52222915701
APS10007269701
CAQH1155450301
MAMSI UNITED HEALTH CARE212402801
BLUE SHIELD63662901MD01
AETNA BEHAVIORAL HEALTH728458901
333404000MD05
MAGELLAN BEHAVIORAL HEALT72129800001
MHN AND TRICARE32819601
VALUE OPTIONS GREAT WEST48750601
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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