Provider Demographics
NPI:1073719670
Name:BARSHOP, SUSAN A (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:BARSHOP
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18298 MEANDERING WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2765
Mailing Address - Country:US
Mailing Address - Phone:972-867-7991
Mailing Address - Fax:
Practice Address - Street 1:18298 MEANDERING WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-2765
Practice Address - Country:US
Practice Address - Phone:972-867-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15701101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional