| 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 |