Provider Demographics
NPI:1619868577
Name:SUSAN KOUZEL, RD LLC
Entity type:Organization
Organization Name:SUSAN KOUZEL, RD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOUZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-431-6892
Mailing Address - Street 1:115 HAMPSHIRE SQ SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-5036
Mailing Address - Country:US
Mailing Address - Phone:703-431-6892
Mailing Address - Fax:
Practice Address - Street 1:1875 CAMPUS COMMONS DR STE 225
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1533
Practice Address - Country:US
Practice Address - Phone:703-431-6892
Practice Address - Fax:571-617-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty