Roark, Susan Leslie

Roark, Susan Leslie is an individual health care provider with primary practice located at 918 9 1 2 St Ne Susan L Roark Lpc, Charlottesville VA 22902-5311. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Roark, Susan Leslie can be contacted via phone (434) 296-3850.

Contact Information

Primary practice address
918 9 1 2 St Ne Susan L Roark Lpc Charlottesville VA 22902-5311
Phone: (434) 296-3850
Fax: (434) 296-2928
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701002014 Virginia

Profile Details

NPI number 1568524957
LBN Legal business name Roark, Susan Leslie
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568524957 NPPES
Other 087527 SOUTHERN HEALTH
Other 521336 SOUTHERN HEALTH
Other 153886 SOUTHERN HEALTH
Other IP287876 SOUTHERN HEALTH
Other 5463577 SOUTHERN HEALTH

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