MEDICARE: SUSAN E VLAJK ACSW,LCSW

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
1	1041C0700X	Clinical Social Worker	CP00939355	WV

General Provider Information

NPI Number	:	1538208145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN E VLAJK ACSW,LCSW

Provider Business Mailing Address
First Line	:	337 HOLT LN
Second Line	:
City	:	LEWISBURG
State	:	WV
Zip	:	24901-1750
Country	:	US
Telephone Number	:	304-647-5826
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 COURTNEY DR
Second Line	:
City	:	LEWISBURG
State	:	WV
Zip	:	24901-2574
Country	:	US
Telephone Number	:	304-647-5826
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	03/10/2026

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