National Provider Identifier Database

SUSAN B FOGG, LPC – NPI #1477889111
Professional


Contact Information

SUSAN B FOGG, LPC
19873 RIVERSIDE DRIVE
GRUNDY, VA24614
Phone: 276-210-4618
Fax:
Website:
Specialty Taxonomy Code
* Professional 101YP2500X

* Indicates primary specialty

NPI Profile & details for SUSAN B FOGG

NPI Number 1477889111
Credentials LPC (Licensed Professional Counselor)
Entity Individual
Enumeration date 10/31/2009
Last updated 02/16/2012 - About 14 years ago
Sole proprietor1 Yes
Identifiers
  • VA License #: 0701004695
  • VA Medicaid: 12029478
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for SUSAN B FOGG, LPC

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