Individual provider Active NPI

Susan McGilloway, LCPC

  • Professional Counselor
  • Frederick, MD
National Provider Identifier
1710416631
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC12959 Issued in MD
Practice address
1301 Holling PL Unit 407
Frederick, MD 21701-5062
Phone
(172) 680-8584
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 262557 KY
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LC12959 MD Primary

Addresses

Primary practice location

1301 Holling PL Unit 407
Frederick, MD 21701-5062

Mailing address

1301 Holling PL Unit 407
Frederick, MD 21701-5062
Phone (172) 680-8584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240823002690 DC Practitioner - Mental Health Counselor 7214476084 Reassigns benefits to 1 organization
I20251013002133 MD Practitioner - Mental Health Counselor 7214476084 Practice locations: Frederick, MD

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1301 Holling PL
Unit 407
Frederick, MD 21701-5059

1301 Holling PL
Unit 407
Frederick, MD 21701-5062
Phone (417) 268-0858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
262557KYMDProfessional Counselor
LC12959MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lotus Psychotherapy Services Single Specialty CurrentSince Sep 20, 2022 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Jul 9, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 2

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1710416631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 HOLLING PL UNIT 407",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015062",
            "telephone_number": "172-680-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 HOLLING PL UNIT 407",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015062",
            "telephone_number": "172-680-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLOWAY",
        "first_name": "SUSAN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "262557",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.