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General NPI Number Information
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NPI Number | 1871684902
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Entity Type | Individual
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Provider Name | JANET SUSAN SPROUSE LPC
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 1301 PETERS CREEK RD NW
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City | ROANOKE
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State | VA
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Zip | 24017
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Country | US
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Telephone | 540-904-6799
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Fax | 540-904-6369
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Provider Business Mailing Address
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Address Line | 2694 SUMMIT RIDGE RD
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City | ROANOKE
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State | VA
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Zip | 24012-6933
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Country | US
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Telephone | 540-977-1286
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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 | 0701003325
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License Number State | VA
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