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NPI Code Detail

MEDICARE: MS. SUSAN C MACLANE LPC, CEAP

MEDICARE: MS. SUSAN C MACLANE LPC, CEAP
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
1101YM0800XMental Health Counselor0701002067VA

General Provider Information

NPI Number : 1235489246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN C MACLANE LPC, CEAP
Provider Business Mailing Address
First Line : 2506 N UPSHUR ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22207-4060
Country : US
Telephone Number : 703-528-4125
Fax Number : 703-528-1744
Provider Business Practice Location Address
First Line : 2506 N UPSHUR ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22207-4060
Country : US
Telephone Number : 703-528-4125
Fax Number : 703-528-1744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2012
Last Update Date : 09/17/2012

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