Individual provider Active NPI

Susan Ann Beadle-Lynch, LCSW-C

  • Clinical Social Worker
  • Severna Park, MD
National Provider Identifier
1811048259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10202 Issued in MD
Practice address
650 Ritchie Hwy
Severna Park, MD 21146-3916
Phone
(410) 315-9350
Fax
(410) 315-9353
NPI assigned
Jan 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10202 MD Primary

Addresses

Primary practice location

650 Ritchie Hwy
Severna Park, MD 21146-3916

Mailing address

650 Ritchie Hwy
Severna Park, MD 21146-3916
Phone (410) 315-9350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 23, 2022 through Feb 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10202MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Counseling Center, LLC 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811048259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463916",
            "telephone_number": "410-315-9350",
            "fax_number": "410-315-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463916",
            "telephone_number": "410-315-9350",
            "fax_number": "410-315-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEADLE-LYNCH",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.