Active NPI
Susan Fetcho, LCPC
- Professional Counselor
- Baltimore, MD
National Provider Identifier
1649607490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC0723
- Practice address
- 60 Mellor Ave
Baltimore, MD 21228-5104 - Phone
- (410) 788-5483
- NPI assigned
- Oct 10, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC0723 | MD | Primary |
Addresses
Primary practice location
60 Mellor Ave
Baltimore, MD 21228-5104
Mailing address
3729 Font Hill Dr
Ellicott City, MD 21042-4932
Phone (410) 313-9475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC0723 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Baltimore, MD
- NPI 1790112746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381363200000",
"number": "1649607490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3729 FONT HILL DR",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210424932",
"telephone_number": "410-313-9475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 MELLOR AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212285104",
"telephone_number": "410-788-5483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETCHO",
"first_name": "SUSAN",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-10",
"last_updated": "2013-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC0723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.