Provider Demographics
NPI:1083156541
Name:MAHANEY, SUZANNE BARTHOLOMEW (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:BARTHOLOMEW
Last Name:MAHANEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAMILTON WAY
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7119
Mailing Address - Country:US
Mailing Address - Phone:214-213-7307
Mailing Address - Fax:
Practice Address - Street 1:200 HAMILTON WAY
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7119
Practice Address - Country:US
Practice Address - Phone:214-213-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16842101YP2500X
GA009218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional