Provider Demographics
NPI:1043547698
Name:WASIK, SUZAN ZULJANI (PHD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:ZULJANI
Last Name:WASIK
Suffix:
Gender:F
Credentials:PHD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8323 LA MATISSE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3357
Mailing Address - Country:US
Mailing Address - Phone:336-202-5009
Mailing Address - Fax:866-903-7036
Practice Address - Street 1:8313 SIX FORKS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5000
Practice Address - Country:US
Practice Address - Phone:336-202-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7536101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional