Provider Demographics
NPI:1427109792
Name:BEDELL, SUSAN E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:BEDELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 OLD BUENA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3736
Mailing Address - Country:US
Mailing Address - Phone:540-463-1848
Mailing Address - Fax:
Practice Address - Street 1:544 OLD BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3736
Practice Address - Country:US
Practice Address - Phone:540-742-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010848551041C0700X
VA09040073091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical