Mrs Susan Buskill Fogg, LPC | |
19873 Riverside Drive, Grundy, VA 24614 | |
(276) 210-4618 | |
Not Available |
Full Name | Mrs Susan Buskill Fogg |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 19873 Riverside Drive, Grundy, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477889111 | NPI | - | NPPES |
12029478 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 0701004695 (Virginia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mrs Susan Buskill Fogg, LPC Po Box 683, Pounding Mill, VA 24637-0683 Ph: (276) 210-4618 | Mrs Susan Buskill Fogg, LPC 19873 Riverside Drive, Grundy, VA 24614 Ph: (276) 210-4618 |
Destiny Rose Goodson, CSAC SUPERVISEE Counselor Medicare: Not Enrolled in Medicare Practice Location: 1520 Slate Creek Rd Ste 201, Grundy, VA 24614 Phone: 276-242-2001 | |
Justin C Blackburn, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1520 Slate Creek Rd Ste 201, Grundy, VA 24614 Phone: 276-242-2001 Fax: 276-312-8337 | |
Robert Auville, M.ED., CSAC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19873 Riverside Drive, Grundy, VA 24614 Phone: 276-244-1380 |