| Susan A. Ponton Therapist Inc | |
|
501 N Mecklenburg Ave South Hill VA 23970-2024 | |
| (434) 447-7447 | |
| (434) 447-3057 |
| Full Name | Susan A. Ponton Therapist Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 501 N Mecklenburg Ave, South Hill, Virginia |
| Authorized Official Name and Position | Susan Allen Ponton (LICENSE PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4344477447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan A. Ponton Therapist Inc Po Box 809 South Hill VA 23970-0809 Ph: (434) 447-7447 | Susan A. Ponton Therapist Inc 501 N Mecklenburg Ave South Hill VA 23970-2024 Ph: (434) 447-7447 |
| NPI Number | 1386805463 |
|---|---|
| Provider Enumeration Date | 06/20/2008 |
| Last Update Date | 06/20/2008 |
| Medicare PECOS PAC ID | 7810413523 |
|---|---|
| Medicare Enrollment ID | O20250425000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386805463 | NPI | - | NPPES |
| 010030692 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701003560 (Virginia) | Primary |
| Provider Name | Susan Allen Ponton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588672893 PECOS PAC ID: 8729504436 Enrollment ID: I20250425000690 |
| Provider Name | Brittany A Ponton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568085009 PECOS PAC ID: 2769909266 Enrollment ID: I20250508000749 |
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