Provider Demographics
NPI:1043351430
Name:CHEATHAM, SUSANNA (LPC)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:CHEATHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:
Other - Last Name:BROWNLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6450
Mailing Address - Country:US
Mailing Address - Phone:866-401-3057
Mailing Address - Fax:318-868-6430
Practice Address - Street 1:2419 GORDON SMITH DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2318
Practice Address - Country:US
Practice Address - Phone:251-434-3475
Practice Address - Fax:251-434-3985
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2110101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional