MEDICARE: SUSAN KOUZEL, RD LLC

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	101YM0800X	Mental Health Counselor
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1619834660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUSAN KOUZEL, RD LLC

Provider Business Mailing Address
First Line	:	115 HAMPSHIRE SQ SW
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20175-5036
Country	:	US
Telephone Number	:	703-431-6892
Fax Number	:	571-617-0037

Provider Business Practice Location Address
First Line	:	115 HAMPSHIRE SQ SW
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20175-5036
Country	:	US
Telephone Number	:	703-431-6892
Fax Number	:	571-617-0037

Authorized Official
Title or Position	:	REGISTERED DIETITIAN/OWNER
Name	:	SUSAN E KOUZEL
Credential	:
Telephone Number	:	703-431-6892

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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