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NPI Code Detail

MEDICARE: MADELINE SUSS LCSW-C

MEDICARE: MADELINE SUSS LCSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904005045VA

General Provider Information

NPI Number : 1962807313
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE SUSS LCSW-C
Provider Business Mailing Address
First Line : 8550 ARLINGTON BLVD
Second Line : SUITE 310
City : FAIRFAX
State : VA
Zip : 22031-4634
Country : US
Telephone Number : 301-370-5877
Fax Number :
Provider Business Practice Location Address
First Line : 801 N QUINCY ST STE 601
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-1729
Country : US
Telephone Number : 703-812-4642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2014
Last Update Date : 03/12/2025

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Directions to “ MADELINE SUSS LCSW-C” Practice Location

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