Provider Demographics
NPI:1043683592
Name:CHAVARRIA-TORRES, SUSIE (LMFT,LPC-I)
Entity Type:Individual
Prefix:
First Name:SUSIE
Middle Name:
Last Name:CHAVARRIA-TORRES
Suffix:
Gender:F
Credentials:LMFT,LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9560 POTRANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-9601
Mailing Address - Country:US
Mailing Address - Phone:210-346-0008
Mailing Address - Fax:
Practice Address - Street 1:9560 POTRANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-346-0008
Practice Address - Fax:210-346-0008
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202638106H00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist