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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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