Provider Demographics
NPI:1003200627
Name:DAWN SUTTER COUNSELING AND SUPERVISION, PLLC
Entity Type:Organization
Organization Name:DAWN SUTTER COUNSELING AND SUPERVISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-S
Authorized Official - Phone:210-762-4119
Mailing Address - Street 1:3645 BLAKELY ST
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2668
Mailing Address - Country:US
Mailing Address - Phone:210-762-4119
Mailing Address - Fax:
Practice Address - Street 1:468 S SEGUIN AVE STE 203
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7670
Practice Address - Country:US
Practice Address - Phone:210-762-4119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty