Provider Demographics
NPI:1184709966
Name:EATON, SUZANNE ROZGONYI (PSYD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ROZGONYI
Last Name:EATON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 OLD FOREST RD.
Mailing Address - Street 2:SUITE 500 UNIT 1
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501
Mailing Address - Country:US
Mailing Address - Phone:434-609-4099
Mailing Address - Fax:
Practice Address - Street 1:3712 OLD FOREST RD.
Practice Address - Street 2:SUITE 500 UNIT 1
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-609-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003363103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA081378MOtherSENTARA
VA737076000OtherMAGELLAN
VA146203OtherANTHEM