Susan E. Black Sr., MS,CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Locust Grove, VA
NPI 1366599565 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366599565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2002202317 (VA)
- Practice address
- 3420 Lakeview Pkwy
Locust Grove, VA 22508-5664 - Phone
- (540) 972-9606
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002202317 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2002202317 | VA | Yes |
Addresses
Primary practice location
3420 Lakeview Pkwy
Locust Grove, VA 22508-5664
Mailing address
3420 Lakeview Pkwy
Locust Grove, VA 22508-5664
Phone (540) 972-9606
Other providers in Locust Grove, VA
- Sara Virginia Begelton
- Majed Benjelloun
- Christina Berben
- Rastriyata Bhandari
- Bio-Medical Applications of Virginia, Inc.
- Body Soul Well
- Samah Nor Bouyakoub
- Nicolette An Buell
- John M. Bush
- Phyllis Byrne
All providers in Locust Grove, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.