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Contact Information

SUSAN B FOGG, LPC
19873 RIVERSIDE DRIVE
GRUNDY, VA24614
 Phone: 276-210-4618
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for SUSAN B FOGG · (Female)

NPI Number 1477889111
Status Active
Credentials LPC (Licensed Professional Counselor)
Entity Individual
Enumeration date 10/31/2009
Last updated 02/16/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0701004695
  • VA Medicaid 12029478
Hospital affiliation(s) Not Available
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.

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