Individual
MS. SUSAN CAROL ALNASRAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
34 PATCHEN RD, SOUTH BURLINGTON, VT 05403-5704
(802) 658-4208
Mailing address
34 PATCHEN RD, SOUTH BURLINGTON, VT 05403-5704
(802) 658-4208
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000667
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012069
—
VT
01
—
2004643370000
CIGNA PROVIDER NUMBER
VT
01
—
4147104
MVP PROVIDER NUMBER
VT
01
—
69046
BLUE CROSS BLUE SHIELD PR
VT
Enumeration date
12/27/2006
Last updated
07/09/2007
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