Provider Demographics
NPI:1396824769
Name:HELTON, SUSAN SMITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SMITH
Last Name:HELTON
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 1:115 HILLSIDE DR NE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2013
Mailing Address - Country:US
Mailing Address - Phone:276-628-1664
Mailing Address - Fax:
Practice Address - Street 1:115 HILLSIDE DR NE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2013
Practice Address - Country:US
Practice Address - Phone:276-628-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904-0001681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00010133645Medicaid
VA008943087Medicaid
VA800001416OtherUMWA HEALTH/RETIREMENT
VA005574OtherVALUE OPTIONS
VA061982OtherBC/BS ANTHEM
VA54-173774503OtherJOHN DEERE/UBH
VA024956OtherMANAGED HEALTH NETWORK
VA254566000OtherMAGELLAN
VA54-173774503OtherHERITAGE NATIONAL HEALTH
VA655110OtherAETNA
VA0-80348OtherCHIR
VA254566000OtherMAGELLAN