Provider Demographics
NPI:1023189602
Name:PFEFFER, SUSAN MCKOOL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MCKOOL
Last Name:PFEFFER
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 1:7121 RED HORSE TAVERN LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6832 OLD DOMINION DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3887
Practice Address - Country:US
Practice Address - Phone:703-356-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040058721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical