Provider Demographics
NPI:1962807313
Name:SUSS, MADELINE (LCSW-C)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:SUSS
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4634
Mailing Address - Country:US
Mailing Address - Phone:301-370-5877
Mailing Address - Fax:
Practice Address - Street 1:801 N QUINCY ST STE 601
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1729
Practice Address - Country:US
Practice Address - Phone:703-812-4642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040050451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical