Healthcare Provider Details

I. General information

NPI: 1841471182
Provider Name (Legal Business Name): SUSAN C. BRUMFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2234 W MAIN ST
WAYNESBORO VA
22980-1739
US

IV. Provider business mailing address

2234 W MAIN ST
WAYNESBORO VA
22980-1739
US

V. Phone/Fax

Practice location:
  • Phone: 540-949-7045
  • Fax: 540-949-8897
Mailing address:
  • Phone: 540-949-7045
  • Fax: 540-949-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904006689
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: