Medlin, Suzanne Mactaggart

Medlin, Suzanne Mactaggart is an sole proprietor health care provider with primary practice located at 3541 Randolph Rd Suite 206, Charlotte NC 28211-1082. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Agencies / Community/Behavioral Health. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Medlin, Suzanne Mactaggart can be contacted via phone (704) 381-8336.

Contact Information

Primary practice address
3541 Randolph Rd Suite 206 Charlotte NC 28211-1082
Phone: (704) 381-8336
Fax: (704) 381-8332
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C006559 North Carolina
Agencies / Community/Behavioral Health 251S00000X C006559 North Carolina

Profile Details

NPI number 1215228390
LBN Legal business name Medlin, Suzanne Mactaggart
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2011
Last updated Jun 12th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215228390 NPPES
North Carolina MEDICAID 6009037

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