MEDICARE: SUSAN MARGARET ARCHER 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	0904005184	VA

General Provider Information

NPI Number	:	1770631939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MARGARET ARCHER LCSW

Provider Business Mailing Address
First Line	:	6301 BANSHIRE DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-6572
Country	:	US
Telephone Number	:	804-928-1788
Fax Number	:	804-533-4233

Provider Business Practice Location Address
First Line	:	6301 BANSHIRE DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-6572
Country	:	US
Telephone Number	:	804-928-1788
Fax Number	:	804-533-4233

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

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	06/09/2026

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