Individual ProviderSusan Carroll HendersonCounselorBehavioral Health & Social Service ProvidersPractice Address2316 Atherholt Rd, Suite 107, Lynchburg, VA 24501-2100(434) 528-0184(434) 384-0206PECOS EnrollmentBased on the most recent information from CMS, provider Susan Carroll Henderson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1588629752Provider TypeIndividualFull NameHenderson, Susan CarrollTitleMrs.CredentialM. ED., LPCGenderFemaleEnumeration Date4/19/2006Last Updated7/9/2007Contact InformationPractice LocationPractice Address2316 Atherholt Rd, Suite 107, Lynchburg, VA 24501-2100Phone(434) 528-0184FaxUnlisted FaxMailing LocationMailing Address114 Boonsboro Dr, Lynchburg, VA 24503-2102Phone(434) 384-0206FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense0701002960VirginiaProvider IdentifiersIDDescriptionIssuerID11526313DescriptionOtherIssuerCAQHVirginiaID5410657DescriptionMedicaidIssuerUnlistedVirginiaID5410282DescriptionMedicaidIssuerUnlistedVirginia