Provider Demographics
NPI:1467885954
Name:TROYANOS, SUSAN LYNN
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LYNN
Last Name:TROYANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2476 NIMMO PKWY
Mailing Address - Street 2:115
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-2545
Mailing Address - Country:US
Mailing Address - Phone:757-685-7077
Mailing Address - Fax:757-689-3422
Practice Address - Street 1:2476 NIMMO PKWY
Practice Address - Street 2:115
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-2545
Practice Address - Country:US
Practice Address - Phone:757-685-7077
Practice Address - Fax:757-689-3422
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710101655101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)