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General NPI Number Information
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NPI Number | 1962807313
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Entity Type | Individual
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Provider Name | MADELINE SUSS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 801 N QUINCY ST STE 601
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City | ARLINGTON
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State | VA
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Zip | 22203-1729
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Country | US
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Telephone | 703-812-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 8550 ARLINGTON BLVD SUITE 310
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City | FAIRFAX
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State | VA
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Zip | 22031-4634
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Country | US
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Telephone | 301-370-5877
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904005045
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License Number State | VA
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