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ETIENNE FOX LOGAN II
NPI 1346712478
Counselor - Addiction (Substance Use Disorder) in Suffolk, VA

Active since December 31, 2018
1258 HOLLAND RD, SUFFOLK, VA 23434(757) 809-4771(757) 809-4932 Get Directions Write a Review

NPPES record last updated: December 31, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Etienne Fox Logan Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETIENNE FOX LOGAN II (NPI 1346712478) is an individual addiction (substance use disorder) provider in Suffolk, Virginia, licensed in Virginia (0732005011) and active in the NPI registry since December 2018.

NPPES Registry Identity

NPI1346712478
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameETIENNE FOX LOGAN II
Location Address1258 HOLLAND RDSuffolk, VA 23434-6313
Mailing Address55 Beattie Pl Ste 810Greenville, SC 29601-2191 · (864) 527-3145 · Fax (864) 990-0653
Phone(757) 809-4771
Fax(757) 809-4932
Sole ProprietorNo
Enumeration DateDecember 31, 2018
✔ NPI 1346712478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in VA · 0732005011
1258 HOLLAND RD, Suffolk, VA 23434
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY CATHERINE DILLARD
Registered Nurse
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 809-4771
PATRICIA BROWN
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 809-4771
MISS TAKIMA SIMMONS LPC-R, CSAC-S
Counselor (Professional)
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (800) 805-6989
ANTOINETTE L PORTER
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 409-4771
PHILLIP EDWARD MAYBERY CSAC
Counselor
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 439-2698
CROSSROADS TREATMENT CENTER OF SUFFOLK, PC
Clinic/Center (Methadone)
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (757) 809-4771
EBONY IRVIN CCMA
Physician Assistant (Medical)
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (877) 848-9810
BEN DRAGAN ZORN
Counselor (Addiction (Substance Use Disorder))
1258 HOLLAND RD
SUFFOLK, VA 23434
Suffolk City (800) 805-6989

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Etienne Logan's NPI number?

The NPI number for Etienne Logan is 1346712478. It was assigned to this individual provider in the NPPES registry on December 31, 2018.

Where is Etienne Logan located?

Etienne Logan practices at 1258 Holland Rd, Suffolk, VA 23434. The listed phone number is (757) 809-4771.

What is Etienne Logan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Etienne Logan was last updated on December 31, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.