Susan R Allen, CAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fairfax, VA

NPI 1720102817 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720102817
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
89004 (VA)
Practice address
8550 Lee Hwy
Fairfax, VA 22031-1515
Phone
(703) 207-2818
Fax
(703) 207-2838
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
89004VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Past Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 89004 VA Yes

Addresses

Primary practice location

8550 Lee Hwy
Fairfax, VA 22031-1515

Mailing address

2101 E Jefferson St
Kaiser Permanente, Ppqa, 6 West, Attn: Theresa Brooks
Rockville, MD 20852-4908
Phone (301) 816-6660

Other providers in Fairfax, VA

All providers in Fairfax, VA · Addiction (Substance Use Disorder) Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.