Provider Demographics
NPI:1598018285
Name:MYERS, SUSAN MCLEOD (MED, LCMHC, NCC, RPT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MCLEOD
Last Name:MYERS
Suffix:
Gender:F
Credentials:MED, LCMHC, NCC, RPT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MYERS
Other - Last Name:TWYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4231 LAKE CLIFF DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8498
Mailing Address - Country:US
Mailing Address - Phone:336-782-2233
Mailing Address - Fax:
Practice Address - Street 1:4231 LAKE CLIFF DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8498
Practice Address - Country:US
Practice Address - Phone:336-782-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8626101Y00000X
NC8626101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor