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General NPI Number Information
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NPI Number | 1225160922
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Entity Type | Individual
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Provider Name | SUSAN MARIE SCHIRICK MED
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 309 PROGRESS DR
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City | BURGAW
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State | NC
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Zip | 28425
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Country | US
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Telephone | 910-259-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 693 RIVER RD SE
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City | LELAND
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State | NC
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Zip | 28451-8438
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Country | US
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Telephone | 336-302-1876
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3151
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License Number State | NC
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