Henderson, Susan Carroll
Henderson, Susan Carroll is an individual health care provider with primary practice located at 2316 Atherholt Rd Suite 107, Lynchburg VA 24501-2100. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Henderson, Susan Carroll can be contacted via phone (434) 528-0184.Contact Information
Primary practice address
2316 Atherholt Rd Suite 107
Lynchburg VA 24501-2100
Phone: (434) 528-0184
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0701002960 | Virginia |
Profile Details
| NPI number | 1588629752 |
|---|---|
| LBN Legal business name | Henderson, Susan Carroll |
| Credentials | M. ED., LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588629752 | NPPES |
| Virginia | Other | 11526313 | CAQH |
| Virginia | MEDICAID | 5410657 | CAQH |
| Virginia | MEDICAID | 5410282 | CAQH |
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