Provider Demographics
NPI:1013364967
Name:SUTER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SUTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 MARYLAND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-2024
Mailing Address - Country:US
Mailing Address - Phone:307-371-6687
Mailing Address - Fax:
Practice Address - Street 1:1107 MARYLAND ST APT 3
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-2024
Practice Address - Country:US
Practice Address - Phone:307-371-6687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional