| Susan Archer, Inc | |
|
4908 Dominion Blvd Ste F Glen Allen VA 23060-6774 | |
| (804) 928-1788 | |
| (804) 533-4233 |
| Full Name | Susan Archer, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4908 Dominion Blvd Ste F, Glen Allen, Virginia |
| Authorized Official Name and Position | Susan Margaret Archer (ONWER) |
| Authorized Official Contact | 8049281788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Archer, Inc 6301 Banshire Dr Mechanicsville VA 23111-6572 Ph: (804) 928-1788 | Susan Archer, Inc 4908 Dominion Blvd Ste F Glen Allen VA 23060-6774 Ph: (804) 928-1788 |
| NPI Number | 1265766208 |
|---|---|
| Provider Enumeration Date | 09/23/2009 |
| Last Update Date | 12/04/2025 |
| Certification Date | 12/04/2025 |
| Medicare PECOS PAC ID | 2062550148 |
|---|---|
| Medicare Enrollment ID | O20091110000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265766208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904005184 (Virginia) | Primary |
| Provider Name | Karen Overmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932258498 PECOS PAC ID: 6800827734 Enrollment ID: I20050830000653 |
| Provider Name | Harriet R Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104083120 PECOS PAC ID: 2860541398 Enrollment ID: I20090512000640 |
| Provider Name | Susan M Archer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770631939 PECOS PAC ID: 6608914783 Enrollment ID: I20091110000496 |
| Provider Name | Mary Mason Whipp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598172660 PECOS PAC ID: 0749506640 Enrollment ID: I20150312001692 |
| Provider Name | Terence D Reaves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295106243 PECOS PAC ID: 0143521641 Enrollment ID: I20151228001544 |
| Provider Name | Paige T Obrien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174970610 PECOS PAC ID: 8729358551 Enrollment ID: I20170726002969 |
| Provider Name | Linda Anne Modelfino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679048342 PECOS PAC ID: 2163766346 Enrollment ID: I20181128001851 |
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